A man who suffered a fainting spell after receiving a flu shot was hit with a $4,692 bill for hospital care, according to a Kaiser Health News report.
Seven things to know:
1. Matt Gleason, a sales operations analyst for Charlotte, N.C.-based IT firm Flexential, was vaccinated in October at his workplace.
2. He reportedly fainted five minutes after receiving the shot, which prompted a colleague to call 911. Mr. Gleason agreed to go to Atrium Health Pineville hospital emergency room in Charlotte after he began vomiting.
3. During his eight hours at the hospital, care included an electrocardiogram, blood and urine tests and a chest-X-ray, primarily to check for a heart attack or other serious condition, KHN reported.
4. The bill for this hospital care totaled $4,692. But KHN states that was reduced to $3,711 after Mr. Gleason's insurer, Blue Cross and Blue Shield of North Carolina, negotiated discounts for the in-network hospital.
5. The general ER admission fee — $2,961 — made up the biggest portion of Mr. Gleason's bill. Mr. Gleason reportedly fought the bill, claiming his ER visit should have been coded at a lower and less expensive level, given his relatively mild symptoms and that he spent most of his time at the hospital in the ER waiting area. His visit was coded as Level 5, the second-most expensive on a six-point scale that indicates the severity and complexity of an ER visit.
6. Blue Cross and Blue Shield of North Carolina said in a statement obtained by KHN that Atrium Health "appears to have billed Gleason appropriately." The insurer noted that while it negotiates discounts for beneficiaries, [out-of-pocket] costs for members after these negotiated discounts "are still far too high"
7. Atrium Health reviewed an appeal from Mr. Gleason and also concluded that charges were "appropriate."
The health system said in a statement that Mr. Gleason arrived to the hospital in an ambulance, and he indicated he had experienced a passing out episode, accompanied with nausea and vomiting. After Mr. Gleason was seen by the physician, it was determined that he needed various tests to determine if there was a serious cause of his fainting spell.
"The symptoms Mr. Gleason presented with could have been any number of things — some of them fatal. Our responsibility was to ensure we treated his condition properly, which we did," hospital officials said.
"In Mr. Gleason’s case, there were several variables that made this a Level 5 visit, including: arriving by ambulance and three or more different departmental diagnostic tests. For example, labs, EKG, X-ray.
"Following treatment, Mr. Gleason contacted Atrium health regarding his bill. As a result of his contact, our team: communicated directly with him, did a financial check of his bill, did an audit of his treatment and followed back up with Mr. Gleason on these findings.
"We don’t ever wish to have unhappy patients. But we believe that based on his acuity and care, the care administered and the [emergency department] charges attributed to Mr. Gleason's visit were appropriate."
Access KHN's full report here.
Editor's note: This story was updated on Jan. 29.
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