How hospitals inflate bills for healthy births by labeling them ’emergencies’ : Shots

When Caitlin Wells Salerno and Jon Salerno’s first son, Hank, was born, his delivery cost the family only $30. Gus’ bill came in at more than $16,000, all told — including the $2,755 ER charge. The family was responsible for about $3,600 of the total.

Rae Ellen Bichell/KHN


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Rae Ellen Bichell/KHN

When Caitlin Wells Salerno and Jon Salerno’s first son, Hank, was born, his delivery cost the family only $30. Gus’ bill came in at more than $16,000, all told — including the $2,755 ER charge. The family was responsible for about $3,600 of the total.

Rae Ellen Bichell/KHN

As a conservation biologist, Caitlin Wells Salerno knows that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources she would owe after the birth of her second son.

Wells Salerno went into labor on the eve of her due date, in the early weeks of coronavirus lockdowns in April 2020. She and her husband, Jon Salerno, were instructed to go through the emergency room doors at Poudre Valley Hospital in Fort Collins, Colo., because it was the only entrance open.

Despite the weird vibe of the pandemic era — the emptiness, the quiet — everything went smoothly. Wells Salerno felt well enough to decline the help of a nurse who offered to wheel her to the labor and delivery department. She even took a selfie, smiling as she entered the delivery room.

“I was just thrilled that he was here and it was on his due date, so we didn’t have to have an induction,” she says. “I was doing great.”

Gus was born a healthy 10 pounds after about nine hours of labor, and the family went home the next morning.

Wells Salerno expected the bill for Gus’ birth to be heftier than the $30 she’d been billed four years earlier for the delivery of her first child, Hank. She’d been a postdoctoral fellow in California, with top-notch insurance, when Hank was born. They were braced to pay more for Gus’ delivery — but how much more?

Then the bill came.

The patient: Caitlin Wells Salerno, a conservation biologist at Colorado State University and a principal investigator at Rocky Mountain Biological Laboratory. She is insured by Anthem Blue Cross Blue Shield through her job.

Medical service: A routine vaginal delivery of a full-term infant.

Total bill: $16,221.26. The Anthem BCBS negotiated rate was $14,550. Insurance paid $10,940.91 and the family paid the remaining $3,609.09 to the hospital.

Service provider: Poudre Valley Hospital in Fort Collins, Colo., operated by UCHealth, a nonprofit health system.

What gives: In a system that has evolved to bill for anything and everything, a quick exam to evaluate labor in a small triage room can generate substantial charges.

The total bill was huge, but what really made Wells Salerno’s eyes pop was the $2,755 charge for “Level 5” emergency services

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