Your Right to a Pre-Treatment Medical Bill Estimate

If you walk into a local store to purchase something you immediately look for the price tag.  It only makes sense for the store merchant to post how much the item will cost so that you can properly evaluate whether to purchase the item.  If the price was not listed in the store, we would be immediately suspicious and concerned that we are going to have to deal with some type of sales tactic.  Many times, we will ignore the product or go elsewhere to find the same product where the price is appropriately listed.

Why do we require the price up front for good and most services, but for some reason, when it comes to our medical care from treating physicians, it is a tedious process to get an estimate of what the treatment will cost?  Pursuant to F.S. 381.026, patients have a right to a pre-treatment estimate upon request.  The correct question is why should we even have to make the request in the first place?

As of 2019, the Florida House of Representatives passed the bill CS/HB 999 with a primary purpose of requiring medical facilities to

Provides personal property exemptions from legal process for medical debts; requires licensed facility to provide cost estimate to patient under certain conditions; prohibits facility from charging patient amount exceeding cost estimate by set threshold; requires facility to provide patient written explanation of excess charges; requires facility to establish internal grievance process to allow patients to dispute charges; prohibits facility from engaging in certain collection activities.

Incredulously, on May 3, 2019 our Florida Senate killed the bill even though the Florida House passed the bill 113 to 1.  There is no reasonable explanation that prohibits healthcare providers from providing the total cost of the treatment.  In fact, Florida law requires many industries to provide the cost up front.  For example, if you bring your vehicle to a repair facility, the repair facility is required to give you an upfront estimate of the total costs to repair your vehicle.  Why shouldn’t our doctors and hospitals be held to the same standard?

Hopefully, our Florida Legislature will take up the issue again in 2020, but for now you can, prior to any appointment, request an estimate for the amount due for your treatment.  If you run into any opposition, ask the medical provider for the Patient’s Bill of Rights form that each provider is supposed to provide upon request.  The bill of rights form specifically sets forth a right to a reasonable estimate for treatment prior to receiving the treatment.  You can then direct the provider to their own form that states the provider is required to provide an estimate for the anticipated treatment.