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New data suggests that EmCare, now one of the nation’s largest physician-staffing companies for emergency rooms, is showing a disturbing pattern. In the case of a small Spokane, Washington hospital, the number of patients coded as having billing for the most complex, expensive level of care quadrupled after the hospital contracted for services through EmCare.
1. How does the contracting process allow for this ER billing surprise?
2. What were the trends in the rates of tests ordered and patients admitted from the E.R. into a hospital after EmCare took over a hospital’s billing?
3. Even if insurers simply pay higher out-of-network bills, what happens?
4. When emergency room doctors work for a company that has not made a deal with an insurer, what happens?
5. California recently passed a law setting a maximum amount that out-of-network doctors can charge patients. What other states have followed suit?
Creswell, J., R. Abelson, and M. Sanger-Katz. (2017). The Company Behind Many Surprise Emergency Room Bills. The New York Times, July 24 (Retrievable online at