Emergency room visits may leave your bank account in need of resuscitation


by By Dave Fehling / 11 News


Posted on August 15, 2009 at 4:39 PM

Updated Tuesday, Oct 20 at 2:56 PM

HOUSTON-You never know when you might end up in the ER - or what it might cost you.

Emergency room visits may leave your bank account in need of resuscitation
March 23, 2009

Armando Miralles found this out the hard way. He was walking his dog when a raccoon jumped out and bit him on the ankle.

It was a very minor bite, but he knew rabies was a possibility.

So, thinking it was better to be safe than sorry, he went to the nearest ER at Memorial Hermann, across from the Memorial City Mall.

A few weeks later, he got the bill.

The total invoice was $7,996.50.

Miralles said $1,164 of that was for "emergency services," which included disinfecting and bandaging the wound.

He thought that was expensive, sure.

"But $7,000 worth of drugs?!" Miralles said.

That's right - there was also a pharmacy charge of $6,800.

That was for one very pricey anti-rabies injection and a much less costly rabies vaccine and tetanus shot.

"The fact that one shot can cost, or two shots can cost $7,000 is beyond my understanding," Miralles said.

So how could a simple visit to the ER for a couple of shots cost that much? Was it a mistake?

To find out what an emergency rabies treatment costs, 11 News checked with the Texas Health Department, which keeps a supply on hand.

The total cost the state pays for an average dosage, according to the department, is about $1,680.

By that measure, Memorial Hermann's charge was roughly three times that amount.

So, what gives?

11 News was told that's how hospitals routinely do business.

Memorial Hermann said Miralles' bill was correct, and that they have to mark up rabies drugs because they're rarely used and have a short shelf life, making it costly to keep fresh supplies on hand.

They also said some insurance companies reimburse only a certain percentage of the hospital's "sticker price" for drugs. So, the higher it is, the more the hospital is paid.

But what if your insurance doesn't cover the ER visit, or you don't have insurance at all?

"That now, through the recession, we're seeing a loss of employer-covered benefits, which means more and more people are getting hit with these billed charges," Houston attorney Ivan Wood said.

Wood, who specializes in the hospital industry, said if you get stuck with a sky-high bill, you need to negotiate.

In other states, hospitals have been sued for trying to charge uninsured patients the full price.

Memorial Hermann said they charge a sliding scale for uninsured charity cases, or if you pay in cash, they'll knock 20 percent off the price.

It's not an issue for Miralles himself - he's covered by Medicare, which will likely end up paying only a fraction of the total bill.

Still, as he left the ER that day and looked up, Miralles said he saw Memorial Hermann's brand-new corporate headquarters.

"Somebody's paying for all that," he said.

He wonders if that's one reason his trip to the ER was so costly.