- Joined
- Aug 10, 2013
- Messages
- 18,169
- Reaction score
- 18,017
- Location
- Cambridge, MA
- Gender
- Male
- Political Leaning
- Slightly Liberal
Today Vox continues its year-long dive into hospitals' ER billing practices with a doozy.
A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills
An ER that's out-of-network for everybody with private insurance is really something.
A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills
On April 3, Nina Dang, 24, found herself in a position like so many San Francisco bike riders — on the pavement with a broken arm.
A bystander saw her fall and called an ambulance. She was semi-lucid for that ride, awake but unable to answer basic questions about where she lived. Paramedics took her to the emergency room at Zuckerberg San Francisco General Hospital, where doctors X-rayed her arm and took a CT scan of her brain and spine. She left with her arm in a splint, on pain medication, and with a recommendation to follow up with an orthopedist.
A few months later, Dang got a bill for $24,074.50. Premera Blue Cross, her health insurer, would only cover $3,830.79 of that — an amount that it thought was fair for the services provided. That left Dang with $20,243.71 to pay, which the hospital threatened to send to collections in mid-December.
Zuckerberg San Francisco General (ZSFG), recently renamed for the Facebook founder after he donated $75 million, is the largest public hospital in San Francisco and the city’s only top-tier trauma center. But it doesn’t participate in the networks of any private health insurers — a surprise patients like Dang learn after assuming their coverage includes a trip to a large public ER.
Most big hospital ERs negotiate prices for care with major health insurance providers and are considered “in-network.” Zuckerberg San Francisco General has not done that bargaining with private plans, making them “out-of-network.” That leaves many insured patients footing big bills.
A spokesperson for the hospital confirmed that ZSFG does not accept any private health insurance, describing this as a normal billing practice. He said the hospital’s focus is on serving those with public health coverage — even if that means offsetting those costs with high bills for the privately insured. . .
But most medical billing experts say it is rare for major emergency rooms to be out-of-network with all private health plans.
An ER that's out-of-network for everybody with private insurance is really something.