A San Francisco hospital charged a family of tourists more than $18,000 for some baby formula and nap time for their infant son after he fell from bed.
Patients transported to hospitals in ambulances may find themselves faced with thousands of dollars in medical bills for vague ‘trauma activation’ – even if they do not get trauma treatment in the end.
Health care costs of every kind have surged upward in recent years as services become more advanced.
Hospitals are marking up prices for services in an effort to recoup the finances that don’t get paid by often under-insured patients who cannot afford them.
Among the big ticket – and mysterious – charges that facilities may charge are for the activation of a trauma team.
A Vox investigation has identified patients who accrued exorbitant bills for this activation – even for services as simple as a bottle of baby formula.
Under the guise of a charge called ‘trauma activation,’ a family visiting San Francisco from South Korea was billed $18,000 for their baby’s nap and formula after a trip to an ER
Back in 2013, when the National Institutes of Health conducted their last major study on emergency room (ER) costs, the median total for such a visit was $1,233.
But patients come to trauma centers for all manner of reasons: everything from the flu to a severe car accident; bruises to heart attacks. So it id no surprise that the associated costs vary widely.
Park Seong-jin and Jang Yeo-im and their infant son visited San Francisco, California on vacation from their home in South Korea, they wound up with a bill for more than $18,000.
All their son ultimately received from Zuckerberg San Francisco General Hospital was a bottle of formula and a few minutes napping in his mother’s arms, Vox reported.
The now two-year-old boy, Jeong-whan, had fallen from the bed in their hotel room, bruised his face, and cried for some time after. Unable to calm him, his parents called 9-1-1 and worried that their son could have an internal injury.
Likely because Jeong-whan was then so young and vulnerable, an ambulance came to pick him up.
At the ER, Jang told Vox that a team of nine or 10 doctors met the family, but it took only a few minutes to determine that nothing was seriously wrong with Jeong-whan.
The family spent another few hours in an exam room so doctors could keep their son under observation. While there, the then eight-month-old drank some formula and took a nap. Then the family was released and continued their vacation.
It took two years for the bill to get to their home.
The uneventful three hours and 22 minutes they had spent at Zuckerberg was going to cost them $18,836.
Their bill lists just two charges: $3,170 for an X-ray and $15,666 for ‘trauma activation 911.’
The latter billing code was added to the roster hospitals can use in 2002 when it was approved by the National Uniform Billing Committee.
Last year, a study of Georgia trauma centers revealed keeping level I and level II trauma centers fully ‘ready’ to handle emergencies cost an average of about $6.8 and $2.3 million each (respectively) a year.
So trauma centers argued that they needed a way to recoup the high costs of keeping a high level ER staffed and equipped, and the ‘trauma activation’ charge was born.
This charge is only supposed to kick in if a patient receives 30 minutes or more of critical trauma care.
Jeong-whan’s trauma team dispersed within a few minutes, according to Vox.
Zuckerberg San Francisco General Hospital and Trauma Center sent a bill for over $18,000 to Jeong-whan’s family with only two items on it: an X-ray and ‘trauma activation’
These kinds of inconsistencies in the trauma activation fee’s application raise suspicions for John Hargrove, a senior researcher at Health Care Cost Initiative.
In cases like Jeon-whan’s, ‘a trauma team is activated, but the patient doesn’t use their resources, so it’s shocking to get the bill,’ he says.
Plus, ‘that charge is not going to include the surgery,’ if one should be necessary, ‘that’s why it’s sort of a strange area of medical billing. It’s not billing for services provided but more for the place where the services were provided,’ Hargrove explains.
In fact, the charge becomes a possibility before a patient even arrives at the hospital.
Emergency responders typically call the hospital to give them a head’s up that they may soon be arriving with a trauma case.
A prepared trauma team might improve the odds for a patient who winds up being in true need of their care, but all of this preparation ‘happens unbeknownst to the patient,’ says Hargrove.
When they get there they may or may not need the some or all of the team that’s assembled for the patient. But they can get charged regardless.
‘People assume you pay for the services you receive. But there are too many moving parts for anyone to get a grasp of what a bill is going to look like until it shows up way after the event occurred,’ Hargrove says.
Not only are there a lot of complex and unpredictable quantifications for procedures, services and preparations for the possibility of services, even after a hospital has decided its prices, shuttered negotiations go on between the facility and a patient’s insurer.
This adds another layer of mystery and inconsistency in medical bills.
‘A good benchmark [of what a service should cost] is Medicare payments,’ Hargrove says.
‘Medicare sets prices. So if the commercial fees are bigger and there’s much more variation around them, what’s going on?’ Hargrove asks.
Jeong-whan’s parents have the same question and are working with a patient advocate to fight their bank-breaking bill.
‘It’s a huge amount of money for my family,’ said his mother, Jang.
‘If my baby got special treatment, okay. That would be okay. But he didn’t. So why should I have to pay the bill? They did nothing for my son.’