Last January, Malcolm Bird took his 1-year-old daughter, Colette, to the local emergency room. His wife had accidentally cut the young girl's pinky finger while clipping her fingernails, and it had begun to bleed. They were nervous, first-time parents who wanted a doctor's opinion.
Colette turned out to be completely fine. A doctor ran her finger under the tap, stuck a Band-Aid on her pinky, and sent the family home.
A week later, something else showed up at home: a $629 hospital bill for the Band-Aid and its placement on Colette's finger.
His insurance had negotiated the price down to $440.30, the amount Bird — who was still in his deductible — was expected to pay. "My first thought was, how could this possibly cost $629?" Bird told me when we spoke in April. "So I wrote the hospital a letter, expecting them to say, yeah, that's a bit excessive, and lower the price."
That didn't happen. The hospital sent him back a long letter explaining why it would stick with the price. The fees, the hospital's leadership responded, were justified — and it ultimately sent his unpaid bill to a debt collection agency.
Bird sent me all his correspondence with the hospital, which I ran by medical billing experts. His experience provides a unique window into how emergency health care billing works in the United States, and how easy it is for customers to end with a surprise bill for a relatively small service — like a Band-Aid on a child's finger.