Why hospitals can't question their bills | Searcy Law

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John Hopkins

Should Hospitals Be Exempt From Questioning Their Bills?

» Written by // February 14, 2012 // ,


Do you believe that before you pay for a service or a product that it is acceptable to ask for what exactly you are being charged?

I would never have thought to ask that question yesterday. The answer seems reasonable and straight forward, right? Of course, if you are buying something you get to ask exactly what you are receiving for the money you are going to pay.

Well, apparently hospitals in North Carolina and, in fact nationwide, do not feel that way. I read this in a case of a North Carolina man, Robert Talford, who had the temerity to question the Carolinas Medical Center about a bill for a three day hospital stay.

Mr. Talford received a hospital bill totaling $19,975 for his three day hospital stay. He disputed it and wanted to know the basis for the charges. Carolinas Medical Center sued him and a state appeals court ruled that because “…the hospital bill submitted into evidence by the Charlotte-Mecklenburg Hospital Authority doesn’t itemize the charges, and the only evidence that the costs were reasonable come from hospital employees… a trial should weigh whether the hospital’s price was right.”

It seems unreasonable to pay an unitemized bill in the amount of over $19,000 and, if the Carolina’s Medical Centers can not substantiate the bill, it seems reasonable that Mr. Talford should be permitted to go to court. Mr. Talford reports that the hospital once charged him 24 times the actual retail cost of a pill, which may be the reason for his questions.

Now, even though the bill is not itemized and they apparently will not provide Mr. Talford with the proof to substantiate the amounts charged, the hospital’s lawyer says:

“If every single contested hearing becomes not an hour or two but days, there will be a significant impact on the court system, as well as on doctors and hospitals,” Fuller said.

“The fact that medications delivered at a hospital are pricy is no secret and no surprise, since charges must cover the overhead costs for nurses, doctors, equipment, meals, and constant cleaning, Fuller said. But it’s also true that a plate of chicken piccata might be $20 at a Davidson restaurant he frequents, and Fuller said he’s willing to pay though the cost of the ingredients may be ten times less because of the value of the eatery’s atmosphere,” Fuller said.

Let’s try to put this all in some perspective and do a “chicken piccata” analysis.

The hospital must charge for the overhead of a nurse delivering me a pill. Okay, but in Mr. Talford’s case, for example, the hospital charged him $14,000 for the stay and $5500 for the bed. So, the bed apparently cost around $1,800 per day and the over $4600 per day was for overhead, like pill delivery. I mean the doctors all charge separately, so we know the hospital charge was strictly for hospital services.

Now, when you break the costs down on a per day basis that sounds a little pricey to me. I will give you that we do not have the details for the charges relating to tests and similar costs, but that is what Mr. Talford is trying to understand, so we are left with the above, primitive, analysis.

I think many of us have had the experience of receiving a bill from a hospital and having to be revived after reading it. Personally, I have never slept in a bed I thought was worth $1800 a night, but that is just me.

I was hospitalized for three days myself. When I received a bill from the hospital for over $30,000, I nearly required hospitalization again, but wasn’t I relieved when the hospital agreed to accept less than $10,000 in payment of all those charges from my insurance company.

Mr. Talford is clearly in the right to have “asked” for a detailed explanation of what he was paying for. After all, there apparently can be as much as a 66% deviation in costs depending on who is paying the bill.

So, if you would ask for a detailed explanation of what is included in the box for a TV before you pay for it, let’s say, I think you are well within your rights to ask about a hospital bill.


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