Zuckerberg San Francisco General Hospital: out of network and aggressively billing


We have written frequently about ER care and ER costs and we have direct experience launching a clinical alternative to the usual emergency department that dramatically lowers the cost of care. But this article from Vox is one of the most shocking and frustrating I have come across. The spokesperson for the Zuckerberg San Francisco General Hospital is complete tone deaf. The basic story is: the hospital is the only level one trauma center in the city; ⅓ of the city’s ambulance runs come to the hospital; Yet “For us, the challenge is we don’t want to become just another hospital,” say Brent Andrew, the hospital spokesperson. “Our mission is to serve people who are underserved because of their financial needs. We feel like we have to recoup what we’re able to from people who are insured because we’re supporting people who don’t have insurance.” So how do they accomplish this? By having no (none!) commercial insurance contracts. The result: anyone with insurance will be “out-of-network” and hence balanced billed for the difference between the charges and what the insurance believes is appropriate, differences that can reach multiple tens-of-thousands of dollars. Patients “...have little protection under state or federal law.” This is a poster case for the complete dysfunction of the ER system. Here is where innovation can make a difference.

Read Vox: A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills


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