ER visit - wwyd?

[nodito]

In November, I brought my 11 month old daughter to the local Emergency Room because she wouldn’t stop crying. She had been sick for a week with what the doctor called a stomach virus and my pediatrician told us to go in to the ER because it was a Saturday and she didn’t seem to be getting better. The ER docs examined her and said it was probably a stomach virus. They wanted to give her fluids but after trying six times (six!) they were unable to get an IV started. At least a half hour of this visit was them repeatedly sticking my daughter while she screamed. They finally said that I could go home and just make sure I kept nursing her and hydrating her and to bring her back in if she seemed dehydrated.

Two or three days pass and my daughter is not getting better and just seemed to be in incredible pain for what was supposed to be a stomach virus. The pediatrician tells me to go back to the hospital. Instead of going back to the local ER, I drive an hour to the nearest big city where they have a well-regarded children’s hospital. She’s admitted and diagnosed almost immediately with intussusception which is an incredibly painful and potentially fatal telescoping of the intestines. Praise God the doctors were able to treat it and we were discharged from the hospital several days later.

Fast forward to this week. We have a high deductible insurance plan and just received a bill for the first ER visit, which is over $600. I’ve already paid the ER and hospital bill for the children’s hospital as well for as the pediatrician who saw her for a couple of sick visits. But I’m having a hard time with this $600 charge. I asked for an itemized bill and this is just the charge for the visit; they weren’t charging me for any procedures or unsuccessful IVs. I realize that we took up the doctors’ time and that they examined my daughter and spent time talking to me about her condition, but they also misdiagnosed her and she had life-threatening condition. They were unable to even treat her with fluids. And then I had to pay a second ER bill because they weren’t able to treat her. AND she had three more days of being in what I’ve since learned is excruciating pain, whereas if they had diagnosed her correctly she could have been treated right away.

So what would you do? Pay the bill? Dispute it somehow? Is that even possible?

 

[Xantippe]

In November, I brought my 11 month old daughter to the local Emergency Room because she wouldn’t stop crying. She had been sick for a week with what the doctor called a stomach virus and my pediatrician told us to go in to the ER because it was a Saturday and she didn’t seem to be getting better. The ER docs examined her and said it was probably a stomach virus. They wanted to give her fluids but after trying six times (six!) they were unable to get an IV started. At least a half hour of this visit was them repeatedly sticking my daughter while she screamed. They finally said that I could go home and just make sure I kept nursing her and hydrating her and to bring her back in if she seemed dehydrated.

Two or three days pass and my daughter is not getting better and just seemed to be in incredible pain for what was supposed to be a stomach virus. The pediatrician tells me to go back to the hospital. Instead of going back to the local ER, I drive an hour to the nearest big city where they have a well-regarded children’s hospital. She’s admitted and diagnosed almost immediately with intussusception which is an incredibly painful and potentially fatal telescoping of the intestines. Praise God the doctors were able to treat it and we were discharged from the hospital several days later.

Fast forward to this week. We have a high deductible insurance plan and just received a bill for the first ER visit, which is over $600. I’ve already paid the ER and hospital bill for the children’s hospital as well for as the pediatrician who saw her for a couple of sick visits. But I’m having a hard time with this $600 charge. I asked for an itemized bill and this is just the charge for the visit; they weren’t charging me for any procedures or unsuccessful IVs. I realize that we took up the doctors’ time and that they examined my daughter and spent time talking to me about her condition, but they also misdiagnosed her and she had life-threatening condition. They were unable to even treat her with fluids. And then I had to pay a second ER bill because they weren’t able to treat her. AND she had three more days of being in what I’ve since learned is excruciating pain, whereas if they had diagnosed her correctly she could have been treated right away.

So what would you do? Pay the bill? Dispute it somehow? Is that even possible?

$600 is getting off pretty lightly with regard to ER, unfortunately.

I think morally you’re on very solid ground, but I suspect that you’re not going to get very far with this.

Thank goodness the real ailment was caught!

Come to think of it, maybe you should request a meeting with the first hospital to talk about your case and ask that they educate their staff so that this medical mistake will not happen again. At a minimum, I think you should send a letter so that they are aware that there was a misdiagnosis.

 

[PaulfromIowa]

The question is does this failure to diagnose rise to the level of malpractice somehow? You need an expert to tell you that.

 

[ChurchSoldier]

I would also ask the hospital if there are any additional costs. Sometimes the first doctor bill does not include facility charges or other items.

I would speak directly to the practice or group which runs the ER (our local ER is run by a different company than the hospital in which it resides) and explain the situation and see if they will reduce the bill.

If they wouldn’t I might pay an attorney $150 to write a letter asking them to explain their view of your concerns. I would think they would be much more reasonable.

To you $600 is a lot, to them it’s not much.

Good luck.

 

[Xantippe]

I would also ask the hospital if there are any additional costs. Sometimes the first doctor bill does not include facility charges or other items.

I would speak directly to the practice or group which runs the ER (our local ER is run by a different company than the hospital in which it resides) and explain the situation and see if they will reduce the bill.

If they wouldn’t I might pay an attorney $150 to write a letter asking them to explain their view of your concerns. I would think they would be much more reasonable.

To you $600 is a lot, to them it’s not much.

Good luck.

Very good advice!

 

[Irishmom2]

I would not pay the bill until you were able to meet in person with hospital administration. And I don’t mean the billing department either.

I would ask them to explain why you should pay a bill when they could not get an IV in 6 times, when they essentially gave up on your daughter in edition to misdiagnosing her problem as a stomach virus. Ask them why you should pay a bill that, if you had listened to them that it was probably a stomach virus, it would have caused your daughter endless pain. Ask them how they can stand there and say you owe them anything when they were absolutely wrong in their diagnosis, and could have been fatal had you not gone elsewhere for competent care.

Some people would say pay it, that you can’t fight with a hospital. Some would say they should be paid for their (incorrect) use of time.

And it may end up that legally, you will have to pay it. But we would not pay it without a fight.
Take the bill from the second ER and the diagnosis with you. Show them. Ask them again why you should be paying their bill.

 

[Viki63]

I would not pay the bill until you were able to meet in person with hospital administration. And I don’t mean the billing department either.

I would ask them to explain why you should pay a bill when they could not get an IV in 6 times, when they essentially gave up on your daughter in addition to misdiagnosing her problem as a stomach virus. .

I agree with this advice. I can’t imagine a hospital being unable to get an IV in a child, although an IV wouldn’t have solved the problem. And the misdiagnosis might have been fatal, as someone mentioned.
At least I would expect them to cut the bill in half.
I had a doctor order a CAT scan but forget to get pre-authorization, so they billed me for a $4000 procedure. The doctor ended up splitting the cost with me.
If they won’t budge, I suggest consulting an attorney; many will do a free 15 minute consult.
So glad your baby is all right.

.

.

 

[EasterJoy]

I would not pay the bill until you were able to meet in person with hospital administration. And I don’t mean the billing department either.

I would ask them to explain why you should pay a bill when they could not get an IV in 6 times, when they essentially gave up on your daughter in edition to misdiagnosing her problem as a stomach virus. Ask them why you should pay a bill that, if you had listened to them that it was probably a stomach virus, it would have caused your daughter endless pain. Ask them how they can stand there and say you owe them anything when they were absolutely wrong in their diagnosis, and could have been fatal had you not gone elsewhere for competent care.

Some people would say pay it, that you can’t fight with a hospital. Some would say they should be paid for their (incorrect) use of time.

And it may end up that legally, you will have to pay it. But we would not pay it without a fight.
Take the bill from the second ER and the diagnosis with you. Show them. Ask them again why you should be paying their bill.

First of all, wait until her follow-up visit, to have a chance to talk this over with her physician and to see how serious and how common this misdiagnosis is. Then yes, gather up her records and ask for answers before you pay a dime.

They failed to diagnose her condition and they failed to even hydrate her. They did nothing for her and then sent her home. Yes: Why is it that you’re getting a bill, again? I’d absolutely ask that question.

Remember, however, that the hospital does not know what happened after you left with your daughter. The doctors wrote a note and put in codes for billing that the billing department dutifully turned into a bill. They never hear from Hospital II about what happened. You are bringing them up to speed. Perhaps they will backtrack, when they have all the facts. Be firm, but try not to ambush their administrator. They might be rather refreshed by that. Do not, however, say or imply that you have ruled out exploring legal action or a complaint to the medical board. Don’t threaten that, but don’t say you have no plans for that, either. Keep the conversation on the point you are raising.

Do not sign anything and do not admit anything until you are sure their offer represents a fair solution to your problem. The hospital administrator is on the hospital’s side first and on your side second. Don’t forget that.

 

[Luz_Maria]

First of all, wait until her follow-up visit, to have a chance to talk this over with her physician and to see how serious and how common this misdiagnosis is. Then yes, gather up her records and ask for answers before you pay a dime.

They failed to diagnose her condition and they failed to even hydrate her. They did nothing for her and then sent her home. Yes: Why is it that you’re getting a bill, again? I’d absolutely ask that question.

Remember, however, that the hospital does not know what happened after you left with your daughter. The doctors wrote a note and put in codes for billing that the billing department dutifully turned into a bill. They never hear from Hospital II about what happened. You are bringing them up to speed. Perhaps they will backtrack, when they have all the facts. Be firm, but try not to ambush their administrator. They might be rather refreshed by that. Do not, however, say or imply that you have ruled out exploring legal action or a complaint to the medical board. Don’t threaten that, but don’t say you have no plans for that, either. Keep the conversation on the point you are raising.

Do not sign anything and do not admit anything until you are sure their offer represents a fair solution to your problem. The hospital administrator is on the hospital’s side first and on your side second. Don’t forget that.

Perfect!

 

[YADA]

The question is does this failure to diagnose rise to the level of malpractice somehow? You need an expert to tell you that.

There is this …

Food for thought - the first hospital was not the only one to miss the real issue - as you took your daughter to your family pediatrician first - the medical professional also misdiagnosed this issue … sadly minor stomach ailments are probably the most common ailment young children present - and only after the normal times for recovery to occur and which fail to present - might doctors begin to look for other causes … thus that second hospital had access to medical records [yes - they can get them from your doctor and the other hospital] and your description of symptoms and remedies and time lapse to draw from in forming their diagnoses …

That said - I would attempt to negotiate a reduction or even a waiver in the bill - and if you discuss this issue in a matter of fact manner - you might see the bill reduced significantly

Remember too that young children - especially very young non verbal children - cannot tell with specifics about where it hurts or in what manner … Even children who can talk are not that helpful … as the parent of a child who over 37 years ago was diagnosed with salmonella poisoning - I can tell you that that diagnosis was not easily made …

We were expecting a second child at the time and our 2 -1/2 year old began suffering intermittent stomach pain … at first we thought it was jealousy over the impending birth - it was a stressful time and kids feel that … when it became worse - we took him to our family doctor … he could not find anything … when our son got increasingly worse a couple of days later - we called the office.

Our doctor - was on his day off - we were reluctant to put the child through the same battery of tests with one of the other doctors and also the expense … so I asked for his home number and reached his wife - he was out … when he returned and she told him we called - he called and told us to meet him at the hospital -

In the end, he ended up admitting him - put him in isolation protocols as a precaution and the diagnoses came two days and a very sick baby later -

 

[LoveMercyGrace]

Attempting to start a line, an IV, six times is considered abuse. The legal limit is three

attempts.

I would not pay the bill right away, and I would request a visit with whomever is in charge.

Misdiagnosing to a potentially fatal problem is a serious matter.

so very happy your baby is now ok!

God Bless

 

[EasterJoy]

Perfect!

I asked someone who knew about this kind of thing, and they said they’d call the hospital, calmly explain the situation, offer to send the patient’s medical record from the hospital that actually got it right, if necessary, but then tell them you expect them to withdraw the bill. If they say they aren’t going to do that, inform them that you are not going to pay it. The doctors failed to do the right tests, failed to do anything at all for the patient, and because of their failure to diagnose and treat a very serious problem the results could have been worse than they were. You got no service, you are not paying anything, and you can’t imagine there is a jury in the world that would see it otherwise.

If the hospital says they’ll take you to court (which they are very unlikely to do), tell them you think the jury is more likely than not going to find in your favor and require the hospital to pay your legal bills on top of their own, plus you will be certain to lodge a complaint with the medical board for this incompetence. That is probably what will happen and so the hospital will probably eat the bill.

If you don’t see yourself making this kind of a call, find someone firm and professional to call on your behalf.

 

[EasterJoy]

Attempting to start a line, an IV, six times is considered abuse. The legal limit is three attempts.

In what state is there a legal limit on the number of attempts to start an IV line? I have never heard of that one. What are you going to do if the patient needs to have an IV (which they usually do, or at least is expected to probably need one)? Say, “Sorry, but the law only allows three attempts, so you don’t get your IV treatment”? That’s unimaginable.

 

[acadiANNA]

I know our local hospital will allow people who have no insurance to pay half of the total amount of the bill. I would take the advice of those who say go and speak to the billing department supervisor and if that doesn’t work, go to the Administrator. I would tell them exactly what happened. I would go very soon. Good Luck. Keeping you in prayer.

 

[mommy_k]

I would send a certified letter with the details of what happened to the administrator or person in charge. I would request in the letter that the bill be removed and to send this to me in writing.

I would follow up in a few days on the phone too.

 

[EasterJoy]

I would send a certified letter with the details of what happened to the administrator or person in charge. I would request in the letter that the bill be removed and to send this to me in writing.

I would follow up in a few days on the phone too.

That sounds very reasonable, and pennies on the dollar to the trouble they could have gotten from this. I hope they take care of it right away for you!

 

[JillyAnn]

1. We don’t have enough information to make that decision for you. We are not attorneys. We don’t know what diagnostics were performed by her pediatrician or Hosp #1. While I agree talking to the hospital administrators to gain a better understanding of what happened is a good idea, you need to go with someone who understands medicine. My guess is a lot of what they say will get misinterpreted.
2. You need an attorney. However, it will cost you more to consult with an attorney than it will for you to pay the bill.
3. As a point of reference , it costs upwards of $500 just to ride in an ambulance on a gurney with a neck brace.
4. There are legal limits to trying for an IV? That’s new to me…they could have put an itraosseous catheter in if they couldn’t get an IV. They face that no ones could get an IV is disturbing…maybe she needed to be sedated to get the IV.

From a personal standpoint, my friend’s baby girl had the same problem. She was undiagnosed by 2 different physicians. We discovered the problem not only because she wasn’t feeling well, but Grandma and I saw she was having jelly like stool, which, in children, is virtually diagnostic for intussusception. She recovered fine once she was treated.

That said, Intussusception isn’t usually a primary diagnosis. It is usually secondary to some GI disease. So, she probably wasn’t misdiagnosed but developed the intussusception because the GI disease was not brought under control quick enough.

 

[Hoosier_Daddy]

1. We don’t have enough information to make that decision for you. We are not attorneys. We don’t know what diagnostics were performed by her pediatrician or Hosp #1. While I agree talking to the hospital administrators to gain a better understanding of what happened is a good idea, you need to go with someone who understands medicine. My guess is a lot of what they say will get misinterpreted.
2. You need an attorney. However, it will cost you more to consult with an attorney than it will for you to pay the bill.
3. As a point of reference , it costs upwards of $500 just to ride in an ambulance on a gurney with a neck brace.
4. There are legal limits to trying for an IV? That’s new to me…they could have put an itraosseous catheter in if they couldn’t get an IV. They face that no ones could get an IV is disturbing…maybe she needed to be sedated to get the IV.

From a personal standpoint, my friend’s baby girl had the same problem. She was undiagnosed by 2 different physicians. We discovered the problem not only because she wasn’t feeling well, but Grandma and I saw she was having jelly like stool, which, in children, is virtually diagnostic for intussusception. She recovered fine once she was treated.

That said, Intussusception isn’t usually a primary diagnosis. It is usually secondary to some GI disease. So, she probably wasn’t misdiagnosed but developed the intussusception because the GI disease was not brought under control quick enough.

Yeah.
There are a lot of keyboard doctors and lawyers here…
I’d approach them and ask for it to be forgiven. If they refuse, I’d pay.

But I wouldn’t be happy about it.

 

[EasterJoy]

Yeah.
There are a lot of keyboard doctors and lawyers here…
I’d approach them and ask for it to be forgiven. If they refuse, I’d pay.

But I wouldn’t be happy about it.

Just for the record, I got the advice to refuse to pay the bill from an emergency room doctor and also from a cancer patient who refused to pay a hospital that misdiagnosed him and lost his lab results. Refusing to pay when medical services are incompetent is a real option. Insisting on payment for the misdiagnosis and non-treatment of an infant who ought to have been admitted to the hospital is a big mistake.

The hospital has no way to know they are billing for incorrect care until the patient protests the bill, especially in a case where the patient did not return to their hospital for the correct diagnosis. When they get evidence that they’ve done that, they do not tend to press to get paid. Having said that, hospitals do sometimes turn down people who merely “ask” to have a bill for bad care “forgiven.” It is the patient who is in the position to forgive bad care, not the hospital. Rather, it is better to call and say, “I’m not paying this bill, and this is why. I can supply more evidence in the form of medical records from your competitor who actually got this right, if you need it for your records.”

 

[Irishmom2]

Just for the record, I got the advice to refuse to pay the bill from an emergency room doctor and also from a cancer patient who refused to pay a hospital that misdiagnosed him and lost his lab results. Refusing to pay when medical services are incompetent is a real option. The misdiagnosis of an infant who ought to have been admitted to the hospital is a big mistake.

The hospital has no way to know they are billing for incompetent care, because the patient did not return to their hospital for the correct diagnosis. When they get evidence that they’ve done that, they do not tend to press to get paid.

Thank you for using your contacts, EasterJoy.

Hoosier, I think a lot of people had good advice without actually being a doctor or lawyer, though one never knows who is, or isn’t on CAF. Not everyone puts their life out there.
Also, without giving away details, some people may be advising because of similar circumstances they encountered.