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What You Should Know

If you have been in a recent motor vehicle accident and visited a local hospital please be aware of the information contained here.

I have noticed that patients who have had imaging studies performed at the local for-profit private hospitals after an accident have been charged anywhere from $8,000 to $25,000 for what Medicare would pay about $1000 for the same thing at the same hospital.

By state law all doctors and chiropractors are required to accept twice the Medicare fee schedule for all payments concerning personal injury protection. State law mandates a maximum fee schedule of twice the Medicare fee for all doctors but NOT hospitals. I have noticed some private for-profit hospitals in our area are charging up to 50 times the going rate.

The problem with this rampant overcharging is that the hospital charges devour all your PIP coverage and your balance, copay and deductible is owed by you leaving you with no PIP coverage to pay for any other medical bills. It is simply unfair to you. The solution is to call the hospital 7 days after your visit asking what you were billed for your visit. Use fee schedule below to see if you were billed fairly.

Personally, I would ask to be charged twice the Medicare fee schedule. If they refuse, I would then ask my lawyer to handle the matter.

If the hospital agrees to reduce your bill, get it in writing and call your insurance adjuster and lawyer immediately. The hospitals have been sued for rampant over-billing and have agreed to $220,000,000 of future discounts. The average auto accident patient who had an examination and had a CAT Scan at the hospital should be charged around $1000. I believe a reduction to $1000 for all treatment is reasonable for an emergency room visit.

In my opinion, despite the $220,000,000 settlement, the local hospitals have not changed their billing habits and overcharging all accident patients they see in the ER.

Englewood Hospital billing department phone number is 1-800-247-9122.

Fawcett Hospital billing department phone is 1-800-617-7044.

Bayfront Hospital billing department phone number is 866-481-2553.

Medicare pays about $241 for a complete physical exam (code 99205)

Medicare Pays about $300 for a cat scan (code 70470)

Medicare pays about $62 for Xrays (code 72050)

You were charged $___________________

You should have been charged $_________________

Your agreed reduction charge is $________________________


Auto Accidents | What You Should Know | Plummer Chiropractic and Wellness | (941) 460-0287

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