Illinois woman waited 4 hours in the ER before leaving — they wouldn’t even give her an ice pack. Then, she got a $410 bill

That’s what happened to an Illinois woman, who shared her experience with the Washington Post: waiting for hours, leaving without being seen and then getting a bill.

It’s not an uncommon practice, and you may not have many options to try and fight a bill if it happens to you.

Hours waiting, no help

Autumn Daniels, 32, told the Post that back in April, she had a migraine that did not cease for a week, forcing her to seek care at an urgent care center in Champaign, Illinois. There, she received a nonsteroidal anti-inflammatory drug that she said usually helps her migraines.

The doctor treating her said that if her condition wasn’t improved the following day, she should go to the ER.

When things didn’t improve the next day, her sister took her to the ER at Carle Foundation Hospital in Urbana.

“She said the ER didn’t seem very busy when she registered at the front desk and was taken briefly to an exam room, where a staffer checked her vital signs and asked whether she had migraines frequently. Then they told her to sit in the waiting room until she was called,” the Post report says.

But Daniels waited four hours, vomiting several times an hour from the pain. Since it did not seem that she would be seen soon, her sister took her to another hospital ER, where she received medication after waiting about an hour and a half.

But the first hospital, Carle Foundation Hospital, sent her a bill for $410, an “Emergency Room Level 1” visit, according to the report.

Daniels told the Post that “a staffer checked her pulse, temperature and blood pressure when she arrived,” and that “she received no other services, nor was she seen by a doctor.”

“At one point while they sat in the waiting room, Daniels said, her sister asked for an ice pack for her head, but the staff wouldn’t provide one.”

Enter at your own risk?

According to an investigation by KHN and NPR, “Many patients don’t understand that they can rack up huge bills almost as soon as they walk through the doors of an ER.”

ERs “almost invariably” charge patients as soon as they are registered, according to the investigation, which centers on another case of a patient being charged though they did not see a doctor.

The toddler, who had a burn that the family’s pediatrician said should be seen by the local children’s hospital, was seen by a nurse who inspected the wound and took vitals. She said a surgeon would look at it, but the toddler’s mother took him home after waiting an hour, with the hospital saying to book a followup which was not needed in the end.

The bill was $858.92, which the family was responsible for because their UnitedHealthcare insurance plan had a $3,000 deductible.

The breakdown of the bill showed the nurse’s assessment was $192, “which was discounted by UnitedHealthcare to a negotiated rate of $38.92,” and the rest, $820, was a “facility fee.”

“Hospital officials defend these fees as necessary to keep an emergency room open 24 hours a day as a community asset,” the investigation says.

Facility fees

Autumn Daniels, who was charged $410 after leaving without treatment for her migraine, is covered by a health plan for state employees, but it paid only for the visit to the second hospital.

“Under the terms of her health plan, claims associated with a patient leaving the facility against medical advice are not eligible for coverage,” Leslie Porras, a spokesperson for HealthLink, which administers Daniels’s plan, said in a statement, the Post reported.

While an expert told the Post that ER bills typically itemize physician charges and hospital charges, Daniels’s bill had the single charge, with a standardized numerical code used to document services, known as a CPT code.

The Post reported that the American Medical Association’s CPT guide says triage alone cannot be reported with such a code. And a spokesperson for the AMA, Robert Mills, told the Post that a physician charge under the code used to bill Daniels would typically be much less than $410.

“It is likely the hospital consolidated the provider-billed charge with a facility fee,” Mills told the Post.

What you can do

The NPR and KHN investigation advises considering urgent care for “relatively low-level” issues, since it is “often much cheaper if the center isn’t attached to a hospital.”

Most importantly, if you do go to an ER, be aware that as soon as you register, you will likely be charged.