Actuarial Outpost
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions

Thread Tools Search this Thread Display Modes
Old 07-10-2018, 05:01 PM
The_Polymath's Avatar
The_Polymath The_Polymath is offline
Join Date: Jun 2016
Posts: 1,426
Default The Deplorable Health Chronicles: the "trauma fee"

This is a nice scam. How do they get away with this?

Horrific story in link.

American hospital bills are today littered with multiplying fees, many of which don’t even exist in other countries: fees for blood draws, fees for checking the blood oxygen level with a skin probe, fees for putting on a cast, minute-by-minute fees for lying in the recovery room.

But perhaps the pinnacle is the “trauma fee,” in part because it often runs more than $10,000 and in part because it seems to be applied so arbitrarily.

A trauma fee is the price a trauma center charges when it activates and assembles a team of medical professionals that can meet a patient with potentially serious injuries in the ER. It is billed on top of the hospital’s emergency room physician charge and procedures, equipment and facility fees.

Charges ranged from $1,112 at a hospital in Missouri to $50,659 at a hospital in California, according to Medliminal, a company that helps insurers and employers around the country identify medical billing errors.

“It’s like the Wild West. Any trauma center can decide what their activation fee is,” says Dr. Renee Hsia, director of health policy studies in the emergency medicine department at the University of California-San Francisco.

Comprehensive data from the Health Care Cost Institute shows that the average price that health insurers paid hospitals for trauma response (which is often lower than what the hospital charges) was $3,968 in 2016. But hospitals in the lowest 10 percent of prices received an average of $725 — while hospitals in the most expensive 10 percent were paid $13,525.

Data from Amino, a health cost transparency company, shows the same trend. On average, Medicare pays just $957.50 for the fee.
Reply With Quote
Old 07-11-2018, 09:45 AM
WhosOnFirst WhosOnFirst is offline
Join Date: Mar 2015
Posts: 158

Originally Posted by The_Polymath View Post
This is a nice scam. How do they get away with this?

Horrific story in link.
I'm not familiar with trauma fees in specific but from the article it sounds like this is a service provided that goes above and beyond a normal ER visit type situation. Since invoking these trauma teams means utilization of more resources from the provider side, it makes sense that they want to get paid for those services. I don't know if what is being charged is reasonable but I don't know that facility or professional fees are reasonable either. My general view is that this is another way for hospitals to monetize emergency care and increase their revenues without increasing the amount of care provided. But I always think that because in my experience it always seems like hospitals are trying to increase their revenue without increasing the amount of care provided
Reply With Quote
Old 07-11-2018, 10:52 AM
mathmajor's Avatar
mathmajor mathmajor is offline
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 10,080

Keep in mind insurance company contracts control all of these things. Billed charges are sort of arbitrary. The $1k/$50k comparison is sort of moot.

Cash payers can often apply for sliding scale or other programs to reduce charges.

My hospital bill for an overnight stay for a burn was $10k before negotiated discounts and just over $3k after.
3.14159 26535 89793 23846 26433 83279 50288 41971 69399 37510 58209 74944 59230 78164 06286 20899 86280 34825 34211 70679 82148 08651 32823 06647 09384 46095 50582 23172 53594 08128 48111 74502 84102 70193 | THIS IS CNN | 85211 05559 64462 29489 54930 38196 44288 10975 66593 34461 28475 64823 37867 83165 27120 19091 45648 56692 34603 48610 45432 66482 13393 60726 02491 41273 72458 70066 06315 58817 48815 20920 96282 92540
Reply With Quote
Old 07-26-2018, 01:38 PM
T-roy's Avatar
T-roy T-roy is offline
Join Date: May 2002
College: UW Whitewater
Favorite beer: FFF GBH/NG Moon Man
Posts: 8,776
Blog Entries: 1

I have never even heard of the "Trauma Fee". I would think it'd be a REVENUE code though. Again, never saw it.
Originally Posted by ORLYLOL View Post
Beer is ****ing amazing
Reply With Quote

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

All times are GMT -4. The time now is 08:43 AM.

Powered by vBulletin®
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.21357 seconds with 11 queries