10 Ways to Deal with an Expensive Emergency Room Bill

Here are 10 things you can do to make it easier to deal with an expensive emergency room visit.


For some of us, it's harder to recover from the emergency room bill than from the actual illness or injury. According to the U.S. Dept. of Health and Human Services, there were nearly 53 million emergency room visits at an average cost of $960 in 2009.

Here are 10 things you can do to make it easier to deal with an expensive emergency room visit:

1. Request an itemized statement. There's simply not much you can do with a bill that's not itemized. The hospital owes you a bill that details what services were provided and how much each one cost.

2. Check your statement. Emergency rooms are busy places. Doctors, nurses, and aides rush to keep up with patients. Often doctors and nurses put items on a bill based on their memory. During a busy, shift it's easy for their memory to get overloaded. That could mean that your bill includes items that you did not use.

3. Have a doctor review your statement. Because of their training and experience, doctors and nurses can more easily spot errors in your bill. It's easy for them to notice things that would not have been used on a patient with your condition. They can also more easily identify things that are double billed.

4. Ask the hospital to audit your bill. Hospitals routinely audit some bills to make sure their system is working properly. Ask to have your bill audited. Who would be more likely to find errors than the hospital staff?

5. Consider getting a patient advocate or financial counselor. A patient advocate is someone who is trained to negotiate on behalf of a patient with a medical organization. Often they work for government or non-profits. One such organization is the Patient Advocate Foundation.

6. Talk with the department manager. Explain that the bill is a problem for you. Confirm your desire to pay, but inability to handle a big bill. Don't be confrontational. You want them working with you, not against you. Ask for a reduction. If they can't reduce the bill, ask about a payment plan.

7. Talk with the billing department. Your conversation will be similar to the talk you had with the department manager. Ask about discounts and payment plans. Don't hesitate to ask for reductions that were rejected by the department manager. The department and billing managers have different functions and could be working under different instructions.

8. Be willing to provide some information about your finances. This is especially the case if you're claiming hardship. You probably won't need to provide a lot of details. A copy of your pay stub or tax return should be sufficient.

9. Write and ask for an adjustment. Mention that you don't have insurance if that's true. Some hospitals have special rates for those without insurance. Point out that HMOs and PPOs pay much less than the amounts you were billed. Ask that your bill reflect those lower amounts.

10. Pay a little bit regularly. The hospital doesn't want to turn your account over to collections. As long as you continue to make small, regular (preferably monthly) payments they'll leave you alone.

Gary Foreman is a former financial planner who founded TheDollarStretcher.com website. The site features thousands of money-saving articles including more on outrageous hospital bills.