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Zuckerberg San Francisco General’s aggressive tactics leave patients with big bills | Vox

Zuckerberg San Francisco General (ZSFG), recently renamed for the Facebook founder after he donated $75 million, is the largest public hospital in San Francisco and the city’s only top-tier trauma center. But it doesn’t participate in the networks of any private health insurers — a surprise patients like Dang learn after assuming their coverage includes a trip to a large public ER.

Most big hospital ERs negotiate prices for care with major health insurance providers and are considered “in-network.” Zuckerberg San Francisco General has not done that bargaining with private plans, making them “out-of-network.” That leaves many insured patients footing big bills.

The problem is especially acute for patients like Dang: those who are brought to the hospital by ambulance, still recovering from a trauma and with little ability to research or choose an in-network facility.

A spokesperson for the hospital confirmed that ZSFG does not accept any private health insurance, describing this as a normal billing practice. He said the hospital’s focus is on serving those with public health coverage — even if that means offsetting those costs with high bills for the privately insured.

“It’s a pretty common thing,” said Brent Andrew, the hospital spokesperson. “We’re the trauma center for the whole city. Our mission is to serve people who are underserved because of their financial needs. We have to be attuned to that population.”

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When Dang first got her $20,243.71 bill, she turned to her health insurance plan, asking it to pay a higher portion of the fees. But the insurance denied that appeal, stating that it had already paid a reasonable fee to cover the services provided.

“You may be held responsible for any charges in excess of the allowable amount when receiving a covered service from a non-network provider,” the letter stated. “This is commonly known as balance billing.”

Premera spokesperson Steve Kipp told me over email that the insurer paid roughly twice what Medicare would pay for the same services. Zuckerberg was billing 12 times the Medicare price. Dang’s employer has since reached out to Premera to see if they can negotiate a lower price directly with the hospital.

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Zuckerberg San Francisco General’s aggressive tactics leave patients with big bills – Vox.