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“I just got a huge bill from North Fulton Regional Hospital after my car accident!” I cannot count how many times we have heard this or a variation of it from anxious new clients in the intake meeting. Across the board at Georgia Regional Hospital, Atlanta Medical Center, South Fulton Regional Hospital and of course, N. Fulton, we are being deluged with exorbitant bills and hospitals filing lien notices.
I do not pretend to be an expert on emerging trends in Hospital administration and finance but I am fairly confident that the 500% over cost markups we see throughout our market has more to do with writing down less than real losses against profit for these for-profit hospitals. As the Atlanta Journal Constitution showed with their study in 2009 on Atlanta area hospitals, there is a huge disparity between for-profit and non-profit hospitals and their rates because there are laws forcing non-profs to cap their bills for low-income patients but no such laws for profiteering hospitals.
What does it all mean? In the AJC article, Deborah Keel, the CEO of North Fulton Hospital said that no North Fulton Regional patients pay the full markup. She went on to explain that they have a “Compact with the Uninsured” program where all uninsured patients receive a discount. I can tell you from experience with our clients that they do indeed receive a self-insured discount some 3-4 weeks after the initial care. Good examples are a client with $88,000 in bills from a leg surgery with reduced bill price at $10,000.00 and another with multiple rib fractures and CT scans with a gross bill of $53,000 that can be reduced to around $13,000.00.
This seems like a reasonable and generous thing to do and for some of you readers you may be grumbling, “well, I ‘m sure if the trial lawyers did not sue hospitals so much we would not have this problem!” Hardly. Look deeper and you will find that the reason Tenet does this is because trial lawyers sued them for collections practices against the poor.
Consejo de Latino Unidos sued Tenet and forced a settlement which included fair treatment for poor patients. The settlement terms included Tenet agreeing to:
It is not just the for-profit hospitals though that jack up the charge relative to cost. According to the AJC, Southern Regional Medical Center charges 332 percent above costs. Saint Joseph’s Hospital of Atlanta’s charge is 314 percent above cost.
Patients with Medicaid or Medicare have other substantial hurdles to climb with hospitals. Hospitals are loathe to billing these programs because they are usually paid at a set per procedure charge which is about 80 percent of the cost of services for Medicaid and 85 to 90 percent of the cost of services for Medicare, according to the AJC article.
The business of running a hospital profitably is probably a tough one, but as this Price Waterhouse summary shows on page 7, the reasons for medical care write-downs are not always as altruistic as they seem. The survey lists a number of legal requirements including the anti-patient dumping law, EMTALA.
The bottom line for uninsured car accident victims in Georgia. Bug the hell out of the hospital billing department and request them to look at all indigent care patient options. Be sure to communicate with your car accident lawyer so that your strategies coordinate effectively. Hospitals are an invaluable resource in the community and they deserve to be paid for their hard work but; they should not profit unjustly on the backs of the accident victims lacking health insurance.