Monday, March 25, 2013

Author Question: Paying Medical Bills

Carrie S. Asks:

My character's ended up in hospital a second time! This time it's not against his will, but the question I have is about paying for his treatment. He's just received treatment for a broken arm, and now he needs to leave. I understand that the hospital would treat him regardless of whether he could pay, but I assume they would also do their best to make sure they were paid if possible.

The situation is this: My character does not have insurance, but he can pay, thanks to a friend. However, he doesn't have any means of payment right now. Nor does he have an address, bank account, or any way for the hospital to make sure he pays up. What would happen? Would they just let him go and hope he was honest enough to come back with the cash?

The hospital in question is non-profit, if that makes a difference.

Jordyn Says:

Wow! Your character is definitely running into some bad luck. 

The hospital would discharge him and hope he pays at some point. If seen in the ED, they may request a copay at the end of his visit (you can't ask for copays until the patient has been seen) but if he doesn't have the money there's not much that can be done at that point. We don't hold people hostage for payment--particularly the nursing staff. It will be the billing department that ultimately follows up.

It really does not make a difference if the hospital is for profit or non profit. Each requires money to keep their doors open. Most hospitals do try to work with individuals and set up payment plans for services rendered.


  1. I've been around a few years so past events (ancient history so to speak) probably doesn't really count. But as newly weds in 1958 my husband lost his job in the recession of 1958 (probably as bad as the recent economic downturn has been) and we had no money. He had "elective" surgery to "cure" headaches by removal of nasal bone spur. This was done at a major teaching/world-renowed hospital by the head of the department of ENT. Suppose to be a "weekend" surgery, it didn't work out that way for him and he was in the hospital for a week with major bleeding. Upon discharge, my husband had to go to "admitting" and sign discharge and payment papers. They argued with him about payment and threatened him. I was working at a very low paying secretarial position. A church friend had arranged for payment of the bill, but it had not all come together at that point.

    So yes, he was detained for awhile. Threatened until he could arrange confirmation to their satisfaction. All of this under a situation where he was physically really not up to it.

    Thankfully, since that time we have been able to have insurance that covered medical issues and situations such as this were avoided.

  2. Vera,

    Yes, "back" then-- I know hospitals were much more inclined to hold one hostage for payment. When I was born (this was a few years later than your story) my parents told me the hospital required payment before they would release me and my parents have the canceled check for $100.00. Good thing they liked me enough to keep me.

  3. Our hospital ED (in PA) comes into the room while you are still waiting for a doctor and asks for insurance cards and wants to know right away how the patient/family is planning to pay for the visit and/or co-pay. Then they oh so nicely (rolls eyes) offer to take a debit card right then and there. Remember this is all before seeing a doctor.

  4. Kristen,

    I actually think they could legally get in trouble for that. We're not allowed to ask for even a co-pay until the doctor has seen the patient. It was that way when I worked in KS as well.