A family member recently visited an ER because they were concerned with some knee pain. The local Urgent Care didn't have an ultrasound, so the ER seemed like the next best option.

They walked in, waited 90 minutes, got an ultrasound that confirmed a non-issue, and walked out. Later they received a $40 bill in the mail for the ultrasound, which they paid.

Fast forward a month and a huge bill arrives. The hospital is charging $8k for "level 4 emergency department visit" and $1.4k for "diagnostic services," there is no itemization beyond that. Our Marketplace Insurance is a HDHP with an $7k deductible, and yet the hospital bill says that insurance has paid 80% already. Even 20% of that is still a huge bill for providing almost nothing.

Is the hospital just bilking the insurance company?

Will the insurance company come back to us for reimbursement up to our deductible?

Is it possible to contest this?

submitted by /u/Soromon
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See also  can someone explain to me why you have to owe back some or all of the Advanced Premium Tax Credit if you CANCEL your marketplace plan and you sign onto your employer's health insurance plan partway through the year?