Consumer Alert

Sick over after-hours charge for emergency room visit

By Mitch Lipka
Globe Correspondent / June 28, 2009
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Q. I went to the emergency room of the Milton Hospital at 6 a.m. on a Sunday. When I got the bill from the physician it stated “$30 additional for after-hours.’’ Is it legal to charge extra like that in an emergency setting?


A. On the face of it, you’re right, that seems like a sketchy charge when you’re going to a place that is intended for treating patients around the clock.

Milton Hospital spokesman Jason Bouffard said billing for an emergency room visit can come from a variety of sources. A lot of the services in the emergency room are provided by contractors - including labs and physician groups. Hospital charges, he explained, would include nursing and medical supplies and do not have an after-hours surcharge.

But it is Harvard Medical Faculty Physicians, a private practice with its own billing procedures, that charges $30 extra for any services provided between 10 p.m. and 8 a.m., he said.

“The rationale for this ‘after-hours’ fee is that during these hours, patient volumes are generally limited, and thus this added fee helps the medical practice to cover the fixed overhead expenses of having an emergency physician on-site during hours of limited patient volume,’’ Bouffard said. “However, because most insurance companies do not reimburse medical practices for this fee, the medical practice ultimately absorbs this cost in most cases.’’

Although the fee is legal, it’s apparently in jeopardy - at least at Milton Hospital. “Although this is a valid service code recognized by the American Medical Association, Milton Hospital administrators are currently working with HMFP to closely examine the viability of this fee,’’ Bouffard said.

It’s also not a charge you’re likely to see at hospitals with staff physicians providing the services.

UPDATE: Since a report about Sears running ads for a product that never appears to be in stock when it’s on sale, more similar complaints have come in. If you have recently gone to a store to purchase something that looked like a good deal in an ad and it wasn’t in stock, let us know. We’d like to hear your story. Tell us the store, the product, when it occurred, and what happened if you dealt with store personnel.

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