Fraudulent hospital charges II: Cover charge

This post is a continuation of last week’s, which was the first in a list of complaints by Elisabeth Rosenthal—physician and journalist—about hospital billing practices following her husband’s bicycle accident.

What Rosenthal calls a "cover charge" is actually a “trauma activation fee” that was billed at $7,143.99. Rosenthal wondered what this was for, since every component of her husband’s care was billed separately. For example, a single CT scan, which covered his head, upper spine, and maxillofacial bones, was billed three times. The trauma activation fee was a separate charge.

The trauma activation fee came into practice following 9/11 when the Trauma Center Association of America, an industry group, convinced regulators that they needed to be compensated for maintaining a state of readiness. “Wait,” Rosenthal says, “isn’t the purpose of an E.R. to be ‘ready?’ Isn’t that why the doctors’ services and scans are billed at higher rates when they are performed in an emergency department?”

This is all new to me. In my own research, I learned that there’s a huge variation in trauma activation fees—such as $1,112 in one hospital and $50,659 in another. Supposedly, the purpose of the fee is to avoid missing a seriously injured patient by engaging a team to examine him or her. But those medical professionals are already in the hospitals and are being paid. One researcher on this topic tells the story of a California hospital that charged a $22,550 activation fee for a young man injured in a minor motorcycle accident. He suffered a cut on his head that required two staples. He received some IV fluid and ibuprofen, but no x-rays, scans, or blood work.

The next time you get a bill for your visit to the ER, let me know what the hospital charged you for the “trauma activation fee.”

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.