Hospital Charges vs. Reduced Payments: A Breach of Care Standards

Hospital Charges

The initial charge when it comes to hospitals is often referred to as the standard set for services before negotiating discounts. The amount that a hospital collects for the designated service is much less than the amount initially charged. Negotiations occur between hospitals and healthcare purchasers, beginning with the original charge amount. Charges can also vary among different hospitals. The reasons for this include, but are not limited to, the following:

• New technology: With the advent of new and evolving technology, some hospitals are implementing innovative and modern approaches to performing daily tasks for their patients. As a result of this change, the hospital’s overall charge is ultimately increased, as it may need to maintain more expensive technological advances.
• Staffing costs: The range of salaries may vary depending on the region in which the hospital is located. Hospitals with staff that specialize in complex procedures, such as treatment for cancer or transplants, may have a higher cost for staffing.
• Intensity of care: Every patient is different from one another. Even patients with the same illnesses or complications may require different care; therefore, some hospitals may need to care for patients with severe complications. This results in variations in charges across hospitals.
• Range of services: Some hospitals provide general care for their patients, while others offer more extensive or specialized care to treat severe illnesses. This difference results in a significant change in the hospital’s overall charges.

Medical Debt

Statistics indicate that over 27 million Americans lack health insurance. Within that number, there are 58% of low-income working adults, 44% of young adults, and 35% of Latinx adults. Due to the growth in the number of Americans lacking health insurance, there has been a significant increase in medical debt.

• 20% of adults without health insurance did not seek medical care in 2018 due to the high cost
• 59% of individuals were contacted by a debt collector over medical debt
• 20% of Americans have at least one medical debt collection item on their credit reports
• 66% of all bankruptcies were related to medical care costs

Unnecessary Payments

Making unnecessary payments is not advised and can lead to significant increases in charges for that individual. It is crucial to understand your rights and benefits to make productive choices toward your health. Understanding state actions and your overall income can help you limit unnecessary payments related to hospital charges. There is a high chance your hospital bill will be reduced or even waived completely. Additionally, it is essential to understand that, according to federal law, a hospital does not have the right to deny a patient emergency room service due to unpaid hospital bills. Therefore, understanding whether or not you qualify for financial assistance is crucial before making any payments.

Reduction in Payments Made to Hospitals

Health insurance programs like Medicare and Medicaid pay hospitals much less than the overall cost of what these programs cover. These programs negotiate lower payments with hospitals. As a result, hospitals must ensure they receive revenue from other sources, such as their patients, in order to offset the costs of providing that care in the first place. This must happen in order for hospitals to keep up with new technologies, replacements of their buildings and supplies, alongside the constant maintenance and improvement of their services.

Breach of Care Standards

A breach of care standards is when a healthcare provider fails to meet the standards established in their professional careers. Understanding these breaches and being able to identify them can be the difference between recovery and deterioration for the patient in question. Breaches in medical care can be detrimental to the patient in need of that care. There can be a delay in injury recovery, oftentimes resulting in the injuries becoming more severe. Additionally, a lack of care can lead to the development of new injuries, causing further harm and distress to the patient. It is essential to understand the potential consequences of breaches in care standards to prevent them from happening to you. Below is a list of medical care breaches:

• Misdiagnosis
• Delayed diagnosis
• Prescribing the wrong medication/dosage
• Surgical errors
• Lacking in the maintenance of proper hygiene protocols

Alongside safety risks, these breaches can lead to many other issues, including the following:

• Legal consequences
• Financial loss
• Reputation damages

How KAASS LAW Can Help

Dealing with hospital charges, medical debt, and breaches of care standards can be overwhelming and add additional stress to an already difficult situation. At KAASS LAW, we understand these challenges and provide experienced legal support. Our team is committed to helping individuals and families secure the care, compensation, and justice they deserve. You do not have to face this alone. Contact KAASS LAW today and take the first step toward protecting your rights.