Health Nut News – by Erin Elizabeth
Charlotte, N.C., resident Matt Gleason hadn’t gotten a flu shot for more than a decade (why start now?) but after having it last winter he decided to go for it; his workplace was offering the jabs in October and they were free! What could go wrong?
Five minutes after the shot, he fainted. Even though he came to rather quickly (he has a history of fainting) a colleague called 911. But when the paramedics got there and sat him up he vomited and that was worrisome enough for a trip in the ambulance to the hospital.
“He spent the next eight hours at a nearby hospital — mostly in the emergency room waiting area. He had one consult with a doctor via teleconference as he was getting an electrocardiogram. He was feeling much better by the time he saw an in-person doctor, who ordered blood and urine tests and a chest-X-ray.
All the tests to rule out a heart attack or other serious condition were negative, and he was sent home at 10:30 p.m.”1
But it was after he got released that things got ridiculous:
“…he was reportedly hit with a $4,692 medical bill — which included a $2,961 ER admission fee and nearly $1,000 in charges for blood tests.
The amount was later reduced by his insurer, Blue Cross and Blue Shield, to $3,711 — but since Gleason had a $4,000 annual deductible, he was still responsible for paying off all of it.”2
What. On. Earth?
Here’s the breakdown of his $4,692 bill:
- $2,961 for the ER admission fee
- $400 for an EKG
- $348 for a chest X-ray
- $83 for a urinalysis
- nearly $1,000 for various blood tests
Again, Gleason’s insurer, Blue Cross and Blue Shield of North Carolina, was able to negotiate discounts for the in-network hospital, thereby reducing his bill to $3,711. But again, with a $4,000 annual deductible, he was responsible for the entire amount. (The ambulance company and the ER doctor billed Gleason separately for their services, each about $1,300, but his out-of-pocket charge for each was $250 under his insurance.1)
Atrium coded Gleason’s ER visit as a Level 5 (which happens to be the second-highest and second-most expensive) on a 6-point scale. A Level 6 code is for someone who has a gunshot wound or major injuries from a car accident. (Are you kidding me?) But when Gleason asked he was informed that because he had received at least three medical tests, his admission was coded Level 5. (He argued he should have paid a lower-level ER fee, considering his relatively mild symptoms and how he spent most of the eight hours in the ER waiting area.1)
Although Matt questioned many of the charges and even fought his bill, Atrium Health defended its care and charges as “appropriate.”
“The symptoms Mr. Gleason presented with could have been any number of things — some of them fatal. Atrium Health has set criteria which determines at what level an [emergency department] visit is charged. In Mr. Gleason’s case, there were several variables that made this a Level 5 visit, including arriving by ambulance and three or more different departmental diagnostic tests.”1
In 2000, The American Hospital Association, the American College of Emergency Physicians and other health groups devised specific criteria to bring some uniformity to emergency room billing. But these guidelines are voluntary and do not determine the prices hospitals set for each ER level.
If he was that ill and needed Level 5 care, why did he spend most of his time in the waiting room? The system is broken. And also, money.
“Blue Cross and Blue Shield (full disclosure- they disgust me and they are MY insurers!) of North Carolina said in a statement that the hospital ‘appears to have billed Gleason appropriately.’ It noted the hospital reduced its costs by about $980 because of the insurer’s negotiated rates. But the insurer said it has no way to reduce the general ER admission fee.
‘We work hard to negotiate discounts that reduce costs for our members, but costs are still far too high,’ the insurer said. ‘This forces consumers to pay more out of pocket and drives up premiums.’”1
Educate yourself first
If you decide to get a flu vaccine or any other vaccine for that matter, make sure you do the work of educating yourself first. Had Gleason done any research he would have learned that fainting is a known reaction (especially for someone who is prone to fainting) but definitely not the only one.
And remember, the emergency room is the most expensive place to seek care. Truthfully, Gleason could have gone to an urgent care facility or his primary care doctor. But hindsight is 20/20.
Just remember, as high deductibles continue to climb (my editor is part of a health share program and loves it- they pay just a little over $500 a month for a family of 4) the emergency room might not be the smartest move- unless you absolutely need it.
We feel bad for Matt and if it were us we wouldn’t ever do the flu shot. Especially after a side effect like that which could have been very dangerous (not to mention, expensive)!
Erin Elizabeth, Founder HNN
SOURCE:
GOT ‘HEALTH CARE’?
‘Health’ insurance all paid up???
You’re good to GO, then. You can trust the ‘experts, they only have your very best interests at heart.
Till your insurance runs out…
… oops.
Let’s see what other insanity awaits on the internet today… been out of touch too much lately.
A local story…
https://mises.org/wire/oregon-defies-logic-statewide-rent-control
And an ex-local story…
https://www.zerohedge.com/news/2019-02-05/us-military-holds-unexpected-war-drill-downtown-los-angeles
Maybe it’ll go ‘LIVE’.
Computer time is up, I’m done for today.
A $4K deductible?!? As if anyone has that kind of money sitting around?!? Most Americans cannot even afford a few hundred dollar car repairs! This is why it absolutely makes my blood boil that illegal immigrants get everything INCLUDING MEDICAL CARE for FREE!
I am not sure I understand this. We have Blue Cross / Blue Shield of Illinois and a $6,000.00 deductible. However, we are not required to pay it all at once. For example, if my wife has a procedure done and the bill is $1,000.00, we might get a bill for 4 or $500.00 dollars and they pay the rest. We basically split the charges until our deductible is met.