PAYMENT OF EMERGENCY DEPARTMENT BILLS BY MEDICAID PATIENTS

Objective: To analyze ED services used by and payment received from pa tients who request to stay and assume responsibility for their bills a fter being denied emergency care payment by their Medicaid providers. Methods: A retrospective chart review over an 18-month period was cond ucted. Charges for these visits were obtained from the physician billi ng service and hospital finance records. Results: Of 193 patient visit s 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 charg es, Three payments amounting to $134 were collected, leaving $46,246 i n nonreimbursed charges. Conclusions: Nearly all patients who elect to be seen in this pediatric ED after being denied by their Medicaid man aged care providers do not pay their bills. ED resources, including la boratory studies, radiographs, and consultations, are used to evaluate and treat these patients without compensation, The cost of this nonre imbursed care must be recovered from other patient care charges.