i'm curious about something on an itemized hospital bill. it says:

"ER TRAUMA LEVEL VI"

then

"ER TRAUMA LEVEL V"

i'm assuming it has something to do with how they rated my condition when i was admitted. just curious as to what the scale is, if a higher or lower number is worse and what the maximum/minimum is?

googling only turned up how er's themself are rated/equipped/required to handle situations. in this case, the lower the number the better the place is. for example, a level I facility is tops.

4/17/2007 10:53:36 PM

sorry, Dr Tdub's office hrs are 8am to 5pm EDT M-F

4/17/2007 10:58:54 PM

lol

4/17/2007 11:01:02 PM

I don't know, but you can bet you were charged twice.

4/17/2007 11:38:10 PM

yeah, that's another reason i'm curious as to what this means. i'm only liable for a small portion of the total bills, but i want to make sure everything is right anyway. that's why i requested an itemized copy rather than just the total they try to send.

everything else on it is pretty self explanatory from the item name. i still really have no way of knowing if i was charged for extra things though. for example, this shows EACH pill i was given. how the hell am i supposed to remember the exact number of each type of pill i took after a total of 27 days in that place.

4/18/2007 12:04:18 AM

the levels are based on the complexity of the care provided to you. level V is lower than level VI.

you shouldn't have been charged for two different levels, though, unless you were there on two separate occasions. which ED were you at?

4/18/2007 12:20:44 AM

that's what i figured it was. i was at wake med. so what's the highest level? the V/VI charges were both dated the night of the accident, so it sounds like one shouldn't be there.

oh, and my visits were as follows:

er the night of the accident, admitted for 15 days

er a couple of weeks after i got out for extreme pain, i was just given higher levels of pain meds and monitored until it subsided. wasn't admitted, released that day.

admitted through the "regular" area for a scheduled surgery. there for 12 days due to complications.

[Edited on April 18, 2007 at 12:50 AM. Reason : visits]

4/18/2007 12:42:04 AM

should have gone to Rex.

4/18/2007 1:24:28 AM

a level 1 is highest priority. As in the dr will post a level one OR case... while the patient is being rushed down to the OR for a life threatening situation.

Quote :

"you shouldn't have been charged for two different levels, though, unless you were there on two separate occasions. which ED were you at?"

not necessarily. his condition could have deteriorated which would require more extensive care

[Edited on April 18, 2007 at 1:52 AM. Reason : .]

4/18/2007 1:50:09 AM

Usually, for billing purposes, I/1 is the lowest level of care. Given that your accident sounded pretty bad I'd say the V/VI fits in line with that increasing scale.

4/18/2007 1:53:32 AM

^^^that's actually what i originally thought, but apparently wake med is MUCH better for traumas. i have to say i was happily surprised at the level of care i recieved. i'd always heard wake med wasn't very good.

Quote :

"level V is lower than level VI."

Quote :

"a level 1 is highest priority"

does not compute.

[Edited on April 18, 2007 at 2:04 AM. Reason : .]

4/18/2007 2:04:14 AM

^which wake med did you go to? the one on new bern or the cary one?

4/18/2007 2:15:14 AM

new bern. ems made the decision, i was too busy trying not to lose conciousness.

4/18/2007 2:25:34 AM

the wakemed in new bern is crap. as far as the levels go, for billing purposes, they increase as the care increases in complexity, hence I < II < III < IV and so on.

i think you're thinking of trauma center ratings - a level 1 trauma center is the best, followed by level 2, and so on.

if your condition deteriorates, they bill you for a more complex treatment option. each visit is billed as one unit.

4/18/2007 2:30:32 AM

perhaps for billing purposes it is different. But a level one patient is our highest priority. For example the operations administrator will call our floor and tell the charge nurse that the ED has a level one patient that needs a bed...


we take care of patients that are level I and II acuity.

4/18/2007 2:54:52 AM

i'm just a lowly EMS provider :\

4/18/2007 2:56:45 AM

Quote :

"the wakemed in new bern is crap"

really? the research i did after the fact showed it was the better place in this area to go for my particular trauma needs. the accident scene was actually much closer to rex, so ems had some other reason for taking me to wake med.

either way, there was an excellent orthopedic surgeon and trauma team ready and waiting when i came in. i don't think i could have gotten a better surgeon or infectious disease specialist. the care/attention i recieved from the nurses wasn't the greatest, but it was adequate. i'm currently undergoing fairly intensive outpatient rehab there as well, and it seems to be good.

also, in these terms of billing, what's the highest level? in ^^ terms i can't imagine i was any lower than a I or II, but i don't know for sure.

i guess i'll call the billing department tomorrow and see what's up with being charged for two levels. not that an extra ~3k really makes a difference on top of ~250k.

[Edited on April 18, 2007 at 3:32 AM. Reason : .]

4/18/2007 3:30:30 AM

250,000? holy mother of god. this accident must have been shit bad.

[Edited on April 18, 2007 at 5:12 AM. Reason : fdgs]

4/18/2007 5:12:15 AM

Quote :

"the wakemed in new bern is crap."

Yeah, it's crap.

It's only the best trauma center in the fucking triangle.

4/18/2007 7:05:36 AM

Ok, you can't tell us the bill is for 250k without telling us about the accident you had. This should be like the 13th commandment.

Don't ask me what the 11th and 12th are...

4/18/2007 7:43:28 AM

search and I'm sure you'll learn plenty about it.

4/18/2007 8:33:10 AM

Just do a search in the Garage for it, I'm sure he's tired of talking about it

4/18/2007 8:48:08 AM

250k... wtf? What did you do that required you to be in the ER for a month?

4/18/2007 8:53:58 AM

message_topic.aspx?topic=442820

4/18/2007 8:57:46 AM

As long as you have insurance, hospitals will regularly add shit to the bill that won't affect you because the insurance company just makes sure it fits within certain parameters and signs off on it.

I've known dentist offices to do this as well.

4/18/2007 8:59:40 AM

evan:

look at the pics of the accident!!!!!

4/18/2007 9:22:10 AM

although it wouldn't have made any difference with that kind of injury why the fuck were you wearing shorts?

4/18/2007 9:42:33 AM

the wake med on new bern isn't crap. If we get a trauma call, we have to take it to a trauma center and the only one in wake county is wake med raleigh. If trauma is really bad or we are closer we go to Duke. There are different levels we call-in on the radio to the hospital...trauma alert or trauma one (one is the worst). Whenever we call in a trauma alert/one, they have to activate the trauma team who are on call and you automatically get charged (if you were brought in by a friend with same injuries you wouldn't be charged that because it wasn't a preactivation...). I heard the activation alone was $10,000!! So maybe you got charged for the activation, plus the team that actually ended up working on you? Sorry, we just drop off patients...don't know what happens to them afterwards haha

4/18/2007 9:48:41 AM

I am sure they are both legit. Ask for an itemized bill if you would like. That would show the cost per pill dose.

Where you at fault for this accident? If not, I hope you got a lawyer to handle settling everything.

I see bills with similar descriptions all of the time. I am sure the first one was the initial stablization and the second was what they decided to do when you got there.


[Edited on April 18, 2007 at 10:52 AM. Reason : k]

4/18/2007 10:42:42 AM

Quote :

"Ok, you can't tell us the bill is for 250k without telling us about the accident you had. This should be like the 13th commandment"

haha, sorry. stowaway linked it. i think the pics are on page 5 or 6.

Quote :

"250k... wtf? What did you do that required you to be in the ER for a month?"

i wasn't in the er that long... i was in the regular hospital that long. the first 15 days and 6 surgeries totalled ~180k. the 12 days and 2 surgeries 3 months later made up the rest. i've still got months of physical therapy and doctor visist to go, and possible 1 more surgery so who knows what the grand total will amount to. all i can say is thank goodness for insurance.

Quote :

"As long as you have insurance, hospitals will regularly add shit to the bill that won't affect you because the insurance company just makes sure it fits within certain parameters and signs off on it."

yeah, i'm sure that's happened. i called BBSNC to see if they would help me fight any inaccuracies, but they basically said they've already payed what they're going to pay on these particular bills so there is no point for them to get involved. like i said before, i only owe a very small percentage of the total but i still want to make the charges as correct as possible. a few bucks off is a few bucks that stays in my pocket.

Quote :

"although it wouldn't have made any difference with that kind of injury why the fuck were you wearing shorts?"

lol. your upper body is the critical thing to worry about (i was wearing a leather jacket). normal pants don't do a whole lot of protecting anyway once you're over parking lot speeds. i had sold my leather pants since i didn't personally own a bike at the time (i was riding Igor's bike).

4/18/2007 10:57:27 AM

i wrecked once in jeans and a leather jacket at about 30 mph...the jeans were absolutely shredded, and i still had some road rash. better that nothing, better than shorts, but not by that much.

leather, particularly riding leathers, are a different animal. i've wrecked at 80-85 mph in full leathers, tumbled about 10 times, and been fine. actually rode for about 2 more hours that day.

wrecked another time at about 50 mph in leathers, went headfirst into a ditch, and walked away (bike was splattered that time).

good gear is worth it's weight in gold, but jeans are, at best, marginal (and nothing would've saved BigBlueRam that day).

4/18/2007 11:18:36 AM

I used to be an EMT and i have never seen anything coded like that from an ambulance point of view

but that was also a long time ago and i am sure things have changed

4/18/2007 11:20:55 AM

i had to get a couple stitches at wake med 2 years ago and they charged me $1200.

I asked the doctor why it was so damn expensive for such a small procedure and he told me (sarcastically) that I was paying for my stitches AND for whatever had to be done for the two patients in the other room because they didn't have insurance...lol

4/18/2007 1:03:32 PM

OH i thought you meant the wakemed IN new bern - which there isn't one. (the one IN new bern - craven regional - IS crap.)

wakemed ON new bern is good.



[Edited on April 18, 2007 at 3:13 PM. Reason : p.s. hi shanndro - see you saturday]

4/18/2007 3:02:05 PM

One time I got a full bill for an MRI...the hospital never bothered to seek the insurance company's share.


It would be nice to get health care reform that doesn't include the current (or Bush's proposed) system of having people with insurance paying for employers and employees that don't have health benefits. We are far less efficient than most first-world universal health care.

4/18/2007 3:08:04 PM

Call the hospital and ask them first, then your insurance and get them to straighten it out for you. You really have about 90 days to pay your bill in full of work out a payment plan. After your insurance goes through they will tell you how much you owe. You then call the hospital and tell them you can pay it in full if they give you a discount, and otherwise you want to make payments. We have done this and every time they gave us 20% off.

4/18/2007 9:17:52 PM

okay, spoke with them today and the did over charge for the trauma level thing. level V should have been removed. not that it makes much difference, but whatever.

makes me wonder what else might be incorrect on there.

4/18/2007 11:15:17 PM