[NPInfo] Maybe you understand this

[David Mittman]

I understand the patient better!


Itemized hospital bill clarifies charges

By Suzanne Palmer, Times Staff Writer

Published Tuesday, August 5, 2008 8:25 PM

Itemized emergency room bill clarifies confusing charges

Q: While on vacation in Florida, I fell and hurt my back. I went to  
the Mease Dunedin Hospital emergency room.

I was examined by a nurse practitioner; X-rays showed I had a broken  
rib. I was prescribed Darvocet and sent home.

Once home I received a bill from the hospital for $798 for medical  
services and $557 for X-rays. Weeks later I got a bill from Coastline  
Emergency Physicians for medical services and an item marked "treat  
rib" for $374 and $144, respectively.

How can I be billed twice for "medical services," especially when only  
the nurse practitioner treated me?

Medicare paid most of the bills, but I'm concerned about fraud.

I'd like an itemized bill, explaining exactly what all these medical  
services were.

Martin Schuller

A: Beth Hardy, public relations representative for Morton Plant Mease  
hospitals, has seen to it that you receive an itemized bill and  
explanation of the services. Any patient may (and should) request this.

It's understandable that you were confused and concerned about the  
charges in light of the fact that you never saw a doctor.

Still, the care you receive in an emergency room is the responsibility  
of the ER physician, whether he or she treats you personally or not.  
That's why you received a bill.

Most emergency medicine doctors do not work for the hospital where  
they practice. That's why the bill was from a third party. In this  
case it was from a medical staffing group that supplies emergency  
physicians to emergency departments.

Many nurse practitioners and physician's assistants are also from a  
medical staffing group. In the case of Mease Dunedin, the nurse  
practitioner who saw you was an employee of the hospital, according to  
Hardy, thus no separate billing for her.

The charges for your X-rays were twofold: The hospital charges for  
taking them and the radiologist charges for reading them.

The rest of the charges were related to the hospital and emergency  
care you received.