WHAT TO DO IF YOU ARE STUCK WITH A BIG U.S. HOSPITAL BILL: Raymond Rupert MD. MBA. Rupert Case Management Inc.

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A number of Canadians end up in hospitals in the U.S. Many of them are either uninsured or under-insured. The result is that they end up stuck with a big hospital bill.

The bills are a lesson in humility. One night in the ER results in a bill of $32,000.  A fractured femur with 3 days in the hospital is $90,000. A ten day stay in the ICU results in a bill of $350,000.

US hospitals use a confusing pricing structure. The highest rate is reserved for insurers. It is called chargemaster. A metabolic panel is $1400 under chargemaster and $27 according to medicare.


Rupert Case Management (RCM) has helped individuals with big US hospital bills for over a decade.

RCM’s process includes a detailed audit, a test for clinical relevance ( was the procedure evidence based and necessary) and a comparative analysis followed by collaborative reviews of the bills with the revenue officers at the hospital.

This has resulted in very positive outcomes for RCM’s clients.


Mr and Mrs D. were in Florida for the winter. Mr D. had a big prostate. He required a catheter. The catheter got infected. He got sick and went to the local hospital. He spent one night in the ER. The hospital bill was $32,000 with $15,000 charged for the CT study.

To get started, Mr and Mrs D. purchased RCM’s Priority Call– an extended healthcare benefits card at www.rupertcasemanagement.com/priority

Using RCM’s unique process, we were able to deliver a significant discount. They were very appreciative of our help.  And that’s our job. We help families who are stuck with big US hospital bills.