Jackson-based University of Mississippi Medical Center updated its emergency room pricing policy after a newspaper investigated a parent's concerns over her child's expensive ER visit, reports the Clarion Ledger.
Amy McIntosh brought her 10-month-old daughter Macy to the ER at Jackson-based Batson Children's Hospital, which is owned by UMMC, after her child woke up with a concerning knot at the base of her skull Dec. 23, 2017.
While Ms. McIntosh wanted to bring Macy to her pediatrician, it was a Saturday, and her pediatrician's after hours were booked for the day, so she headed to the ER.
Physicians in the emergency department spent five minutes face-to-face with the family, confirmed the knots were swollen lymph nodes and discharged Macy with no treatment plan or medication.
A few weeks later, Ms. McIntosh received the $4,661 medical bill for her child's visit. While she was only responsible for $875 of it, she was shocked at the price tag.
"We asked for [a] detailed bill; something had to be wrong," Ms. McIntosh told the Clarion Ledger.
The majority of the bill was an "emergency room-general classification" fee of $4,328. Even though Macy received no treatment from her visit, the family was billed for the second-highest level of severity for emergency room visits — because Macy was under one year old.
UMMC prices ER visits based on a "level," which is determined by the severity of a case, on a scale of one to five. A level 1 charge, the least-severe level, starts at $468. A level 3 charge jumps to $2,048 and a level 5 charge is $4,913, according to the report. Ms. McIntosh was charge for a level 4 visit because of Macy's age.
"No services/treatment provided or documented in Macy's medical records justify a Level 4 ER visit," Ms. McIntosh wrote in an April 13 letter to Batson's CEO Guy Giesecke, according to the Clarion Ledger. "In our view, we are being billed excessively simply for having the perceived ability to pay."
After Ms. McIntosh raised concerns over her child's ER visit, Mr. Giesecke agreed the level designation in Macy's case was an error.
In response to Ms. McIntosh's concerns and a probe into the expensive ER visit by the Clarion Ledger, Mr. Giesecke said it will change its ER pricing policy that states infants under one year old will be classified at a higher severity level.
"One change that will become effective immediately: adjusting the policy that infants under one year old are automatically classified at a higher severity level because of their inherent status as high-acuity patients. This designation will now be limited to patients six months old and younger," Mr. Giesecke said, according to the Clarion Ledger.
Further, a team of UMMC medical and billing leaders proposed a set of changes across the network to help physicians and care teams better classify the level of care.
UMMC officials said the change in policy will likely cut Macy's bill in half.