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These 29 Words Prevent High ER Bills

Updated: May 15, 2023

****You can download the app with these words right into your phone and have them pop up when you fo to the ER. Chances are you reached this blog from your home page quiz. This app can be reached right from your home page****

"Superseding other consents, I consent to responsibility (including insurance) for up to 2 times Medicare following receipt of an itemized bill for appropriate treatment coded at the correct Level."

If you need care in an emergency room, do not sign the financial consent that the hospital or free-standing ER has put in front of you. (The electronic form will require two signatures, the first for treatment and the second to pay for it. Sign only the first.)

Instead of signing the second, demand to have the financial consent printed out and write in this one sentence on your phone, or use our wallet sticker:

SImply peel it off and affix it, like this:


That sentence is Quizzify’s ER Sticker Shock Prevent Consent. We will refer to it here as the Consent. Writing in/sticking on these words will prevent the hospital from charging you a lot of money. Except possibly in Alaska or Hawaii, where everything costs more, the total bill will always be under $1000 if you don't get a fancy scan, or have a procedure performed by an on-call doctor. Regardless, it will be half of what you usually pay.

If you are a Quizzify customer, your Quizzify2Go app will reveal many other reminders of your rights as a patient in the ER and how to use them.

You will also see two phone numbers. (We have hidden the second.) The first is, as noted, a 24/7 expert line to use if indeed a hospital denies you treatment because you are not signing their consent but rather insisting on yours. Our experts will ask you to hand the phone to the intake staff and, if possible, turn the speaker on so that you can hear too. Assuming you have a real emergency (and not just a splinter, for example), our experts can be very convincing on these recorded phone calls.

The second number is in case the hospital “forgets” that they agreed to your Consent, and instead sends you a regular bill. We will “reprice” the bill correctly and send it back, with instructions to re-send you the correct bill and cc us. (Your employer will not know your name.) We will then be available if the situation does not easily resolve, all at no cost to you.

If for some reason you don’t download this information from your home page and need an access number, write to, from your work address, and someone should send it to you. Unlike the emergency hotline, this is not an official 24/7 service, though, and depends on our availability.


FAQs about the Prevent Consent

Q: Why does the hospital have to accept this Consent?

A: The Emergency Medical Treatment and Active Labor Act of 1986 (“EMTALA”) forbids healthcare facilities licensed as hospitals from turning away emergencies because they don’t like your insurance or because you have none. “Emergencies” covers not just ER visits, but also deliveries and admissions that are not planned. This includes COVID, which would virtually always be an emergency. EMTALA does not apply if you schedule a surgery, for example, and check in through the regular admissions department.

Q: Do they have to sign my Consent to accept it?

A: No. It is enough that you don’t sign theirs and write yours in and sign it yourself. Treating you in the ER (or admitting you) constitutes legal acceptance of your Consent unless they write down that they reject your Consent. That very unlikely action on their part should trigger the above-mentioned phone call for our experts to convince them otherwise. No hospital has yet affirmatively rejected the Prevent Consent.

Q: What if I accidentally sign theirs too? It’s on a computer screen, along with the consent-to-treat and if I am in the ER and in need of emergency care, I may accidentally sign both.

A: The Consent says that it “supersedes other consents.” We don’t know what the legal effect of this disclaimer is because it has never been tested in Court. The hospital in question won’t know either. Adding this language adds uncertainty to their case, and makes them even less likely to pursue it against you. To date, no case against a patient using the Consent has gotten to Court. Every case has been settled for the 2x Medicare rate.

Q: Does this mean my insurance doesn't cover it?

A: Your insurance still covers it according to your benefits. It's like paying less for any healthcare service that is covered by insurance. You may have a deductible and you may have a copay or co-insurance (here is the difference between the two) as you always do, but the total bill is treated by your insurance like anything else.

Q: What is so magical about this “2x Medicare" rate?

A: Hospital charges for non-Medicare patients (meaning you) are often a large multiple of what they charge Medicare patients, a price which is dictated by the government. This multiple is especially high for emergency care. The highest we’ve seen is 27x Medicare. Reducing their charge to 2x Medicare results in savings that are so great that we are able to guarantee your employer that your ER bills will be <$1000 (except where scans, stents, broken bone-setting, or procedures by on-call specialists are involved – and those will always be much lower than commercial fees).

Q: Why not only 1x Medicare?

A: Because Medicare is most hospitals’ largest account. It isn’t fair to the hospital for you to pay that price. More to the point, paying 2x Medicare is reasonable enough that no hospital that rejects the Consent could be sure they would win a case in Court against a patient who offered such a reasonable rate. Just to reiterate: no case has ever gone to Court and no hospital has ever rejected the Consent.

Q: If you get admitted, do they have to keep you the whole time?

A: EMTALA requires only that they keep you at the Consent price until you are “stabilized.” They could then transfer you to a public hospital. It is vastly more likely that, once you are stabilized, they ask you to sign a new consent (theirs) which will result in a bill for the remainder of your stay at the regular network rate. The initial days pre-stabilization will still be 2x Medicare.

Q: Could the Consent ever fail?

There are a few free-standing ERs which do have hospital licenses and hence could reject your request for treatment if you do not sign their consent, because they are not required by federal law to do so. The federal law requiring treatment of emergencies applies only to hospitals and free-standing ERs own by hospitals.

Further, your (or your family member’s) reason for going to the ER must be at least arguably a real emergency. For example, a bullseye rash indicating Lyme Disease is not an emergency. Being unable to dislodge a tick that could be transmitting disease to you that very minute might be, and “might be” is probably enough to qualify as an emergency.

Otherwise, if you follow the directions, it works 100% of the time.


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