KGO-TV7 (ABC) San Francisco

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KGO-TV7 On Your Side has uncovered a controversial, and now standard, medical charge you’ve probably never heard of, but there’s a good chance you’ll some day pay.

This is a little known charge that can cost you big time. When we first started looking into to this, we found many hospital workers hadn’t heard of the fee. That may be because this isn’t a charge for services rendered, but for services on stand-by.

Don Cohon spends a lot of days bicycling the back roads of Marin County. It’s usually pleasant, if uneventful. But one day last February, there was a problem.

Don Cohon, Marin: “I was going down towards Stinson Beach and what I remember of the ride is that I saw my front tire blow up and go parallel to the metal rim.”

Don was thrown from his bike and knocked unconscious. He eventually ended up inside an ambulance where he received care and made phone calls canceling that night’s dinner plans.

Since there was a head injury, the paramedics alerted the trauma center at Marin General Hospital.

Don Cohon: “There was a group of people there who met me, and then they kind of evaporated once I got in the hospital and one person stayed with me.”

The hospital declined an on-camera interview, but in a written statement explained how its trauma center works:

“We issue an internal alert and a team of doctors, nurses, respiratory therapists, social workers, etc. immediately report to our trauma room… in some instances… it may be determined … the trauma team was not necessary.”

That’s what happened to Don. After a few tests, some cuts and bruises were attended too, and he was on his way. The real hurt came when he received the hospital bill.

Don Cohon: “For the two hours and forty-five minutes I was there, the bill was $24,000 some odd dollars. And I just couldn’t understand it.”

There were charges for supplies, EKG and the like, all expensive, but understandable. Then there is this, “trauma activation” – that’s being ready for Don’s arrival. A cost of $12,420. The hospital says “the activation fee is not a time or resource-based fee.”

That angers consumer activist Jamie Court.

Jamie Court, consumer activist: “If you have doctors and nurses on the payroll in the building and they go to the emergency room, one floor down, that isn’t worth $12,000.”

Or is it? What do other trauma centers charge? In Palo Alto, Stanford Medical Center charges at most $2,000 for a trauma activation. In Walnut Creek, John Muir Medical Center charges $7,600. In Napa, Queen of the Valley Hospital charges $1,713.89 for a low level activation, $5,974.87 for a high level response. And in San Jose, the Santa Clara Valley Medical Center also has a two-step response: $1,600 and $4,400.

Jamie Court: “Because you fall off the seat of your bicycle, some industry guideline says you can be charged an activation fee for a trauma system that doesn’t even examine you. That’s just wrong.”

And that brings us back to Don, out in eastern Marin, with his take on how the system works.

Don Cohon: “That doesn’t seem right to me. That just doesn’t seem fair.”

Basically here’s what’s happening. Those who are unlucky enough to actually go to a trauma center end up paying a large share of the price tag for having the trauma center available for the rest of us.

Also, there are true costs with being on stand-by, for instance operating rooms must be prepped and ready to go when, for instance, a head injury is called in.

Now, Don has insurance. So the bill is discounted, then his company pays its share. Still Don has a bill of $6,000. The hospital, however, is offering a generous repayment plan.

The lessons here: if you are going to fall off your bike, try to do it on the peninsula.