Emergency physicians' knowledge of the total charges of medical care

Study Objectives: This study aimed to evaluate emergency medical physician's knowledge of the charges for the entirety of medical care provided to patients they treated and discharged from the emergency department (ED). Methods: The study was administered in an academic ED. Patients were eligible for the study if they were discharged from the ED by the attending who first evaluated them. Following patient discharge from the ED, the attending physician and resident were asked to estimate the total billed to the patient (all charges billed to patient before adjustments for insurance provider or coverage status were applied). The median error of the physician's estimate was compared to their years of experience. Results: Physicians underestimated actual total charges 93% (127/136) of the time. The median estimate was 36% (IQR 23%-54%) of the actual final ED charge, representing a median underestimation of $ 1268 (IQR $766-$2347). There was no correlation between degree of error and postgraduate years of the physician. Conclusion: This study demonstrated a significant underestimation of a patient's total charges by emergency medical physicians. There was no correlation in years of experience and ability to accurately estimate charges. While all physicians tended to underestimate charges, physicians tended to have good inter-rater agreement. (C) 2013 Elsevier Inc. All rights reserved.