Payment of Emergency Department Bills by Medicaid Patients

Objective : To analyze ED services used by and payment received from patients who request to stay and assume responsibility for their bills after being denied emergency care payment by their Medicaid providers. Methods : A retrospective chart review over an 18‐month period was conducted. Charges for these visits were obtained from the physician billing service and hospital finance records. Results : Of 193 patient visits identified, 192 charts were located and reviewed for chief complaint, diagnostic tests, and interventions performed. In total, the visits resulted in $18,120 in physician charges and $28,126 in hospital charges. Three payments amounting to $134 were collected, leaving $46,246 in nonreimbursed charges. Conclusions : Nearly all patients who elect to be seen in this pediatric ED after being denied by their Medicaid managed care providers do not pay their bills. ED resources, including laboratory studies, radiographs, and consultations, are used to evaluate and treat these patients without compensation. The cost of this nonreimbursed care must be recovered from other patient care charges.