Childrens Healthcare of Atlanta charging unaffordable prices

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Mar 9, 2019
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#1
I did the research before bringing my child to urgent care and investigated average costs of the urgent care ($100) and average cost of flu test ($5-10). Then I called CHOA to be sure about the charges. The only thing I was told is that "it starts at $75". When I go to my doctor , the visit is $86 so I thought this made sense. No one informed me that the actual office visit is $349 , and no one informed me before the flu test that the cost of that would be $370.
I knew my child had the flu and that is what I told the staff at check-in. That would have been a great opportunity to inform me that I would be paying over $700 to find out if he has the flu. The person on the phone did not have any trouble finding these charges within seconds when I asked on the phone so I'm sure they would have been easily located.Instead, the only information I had was it was $75
While there, I dealt with several people and was asked to pay for the visit before my 1.5 hours of waiting to ever be seen by a doctor.


I have already called 7 times and spoken to at least 4 people. Each person transfers me to someone else, and then I have to leave another message and wait several more days to get a call back.
My bill is $726 for a simple visit and flu test. Nothing else.
I have been told I can receive a 50% discount on that price since I do not carry insurance , but only if I pay within 30 days. This would bring the total to $363, which is still not affordable. I never would have chosen to take my child here if I would have had correct information.
I am willing to pay a reasonable amount, that matches national averages for this service. But this request has been denied several times.



R. V.
 
Mar 9, 2019
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#3
I would like to know who to write a letter to at CHOA so that I can ask for a reasonable payment to be accepted for services. Everyone I speak to sends me to someone else and I am not getting anywhere.
 

jsn55

Verified Member
Dec 26, 2014
7,689
7,497
113
San Francisco
#8
This is just awful. VoR has given you the contacts, all your communication needs to be in writing. I dropped into an urgent care facility in Minneapolis a couple of years ago to get an Rx for meds that I forgot to bring with me. I told the doctor what I wanted and why, she wrote it out and didn't examine me. The doc time was about 3 minutes. The bill was almost $300; I couldn't believe it. We are all making someone rich, that's for sure. I'm glad that the hospital is at least willing to work with you on that horrendous charge. I'm not sure that the clinic staff is aware of what patients are being charged. Something has got to change in this country.
 

weihlac

Verified Member
Jun 30, 2017
1,184
1,117
113
Maui Hawaii
#9
I did the research before bringing my child to urgent care and investigated average costs of the urgent care ($100) and average cost of flu test ($5-10). Then I called CHOA to be sure about the charges. The only thing I was told is that "it starts at $75". When I go to my doctor , the visit is $86 so I thought this made sense. No one informed me that the actual office visit is $349 , and no one informed me before the flu test that the cost of that would be $370.
I knew my child had the flu and that is what I told the staff at check-in. That would have been a great opportunity to inform me that I would be paying over $700 to find out if he has the flu. The person on the phone did not have any trouble finding these charges within seconds when I asked on the phone so I'm sure they would have been easily located.Instead, the only information I had was it was $75
While there, I dealt with several people and was asked to pay for the visit before my 1.5 hours of waiting to ever be seen by a doctor.


I have already called 7 times and spoken to at least 4 people. Each person transfers me to someone else, and then I have to leave another message and wait several more days to get a call back.
My bill is $726 for a simple visit and flu test. Nothing else.
I have been told I can receive a 50% discount on that price since I do not carry insurance , but only if I pay within 30 days. This would bring the total to $363, which is still not affordable. I never would have chosen to take my child here if I would have had correct information.
I am willing to pay a reasonable amount, that matches national averages for this service. But this request has been denied several times.



R. V.
The hospital is not allowed to tell or ask you about cost/charges on check-in in the urgent care or Emergency Department. This practice was stopped because it discouraged people who really need care and leads to bad outcomes. Any hospital-based care, whether urgent care or Emergency Department, will be many times more expensive than an office visit because of fixed overhead costs to care for all comers who are not seen in the office setting.
 

weihlac

Verified Member
Jun 30, 2017
1,184
1,117
113
Maui Hawaii
#10
This is just awful. VoR has given you the contacts, all your communication needs to be in writing. I dropped into an urgent care facility in Minneapolis a couple of years ago to get an Rx for meds that I forgot to bring with me. I told the doctor what I wanted and why, she wrote it out and didn't examine me. The doc time was about 3 minutes. The bill was almost $300; I couldn't believe it. We are all making someone rich, that's for sure. I'm glad that the hospital is at least willing to work with you on that horrendous charge. I'm not sure that the clinic staff is aware of what patients are being charged. Something has got to change in this country.
It is a $3.5+ trillion industry, bigger than the GDP of all but 4 countries in the world. It will not change until it collapses. There is far too much money at stake for anyone to give it up.
 
Mar 9, 2019
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#11
I have emailed using the contact you gave me. They called me back on the phone today. I know I need to avoid the phone, and I have learned this the hard way by experience as well, so what do you suggest when they return an email with a phone call?
 
Dec 19, 2014
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#13
Here is some insight for the OP and for everyone else.

CHOA is a hospital based urgent care. Their list prices are going to be high, as compared to a non-hospital based urgent care.
For a new patient, you were most likely billed a 99203 (new patient - low complexity), or possibly a 99204 (new patient - moderate complexity). Based on your bill of $349, you were most likely billed a 99204.

When they say the visits start at $75, they are referring to the lowest possible E&M code, which is almost always non-applicable to a new patient.

Regarding the influenza test, there are actually multiple type of flu tests. Most hospital systems have gone to a PCR detection system, and believe it or not, the testing cartridges are expensive, and usually run around $50 per test. The list price of $370 is on the high side, as most insurance companies reimburse around $100-120 for the test.

Since you do not have insurance, you are being billed list prices. Insurance companies will all have negotiated a "discount" or as in the case of medicare, there is a maximum allowable. I will not get into the debate of the politics of the above pricing schemes, but am simply giving you insight as to the source of the bill.

Now, you visited the clinic, had services performed and received treatment. So, no one is going to waive the bill.
Your best course of action is to negotiate with the finance department 1) an appropriate discount and 2) a payment plan.
One of the things you can push for, is to look up the medicare maximum allowable prices and counteroffer at those rates.

BTW, not sure where you got your data for the "average" cost of urgent care visits. The average cost of an urgent care visit is more around $150. With your bill of $349, and applying a 50% discount for prompt pay, the cost of $174.50 while higher than average, is not that significantly more than the "average" of $150. Likewise, the test kits for a rapid influenza test average around $18-20/test, and that is the wholesale price of the kits, and if the clinic uses a PCR detection, the kits cost $50 on average. So, a flu test costing $5-10 is not possible, it would be provided at a significant loss.

If working with finance does not yield results, the next step would be to appeal to an executive, either a) the medical director, b) the VP of the urgent care, then c) the CEO.