Whether you are going to a hospital emergency room, a doctor’s office, or a medical imaging facility for x-rays or scans, you will first be presented with an all in one form for your signature, often on an electronic pad, that solicits all at once both your consent to treatment and more importantly your consent to pay all costs associated with the treatment which are not covered by your insurer, or if you are uninsured, to be paid by you alone. Do not sign this form. Instead, bring with you, or write out any available sheet of paper, the following one sentence statement: “I consent to appropriate treatment and (including applicable insurance payments if any) to be responsible for reasonable charges up to but not more than two times the Medicare rate.” This language is recommended by Quizzify, a health care literacy/education company (www.quizzify.com), for all patients outside of Medicare or Medicaid who must navigate the private sector healthcare market. Take a picture of this statement after signing it and before handing it over to the clerk at the reception desk. If the hospital personnel balk at your form, then remind them that federal law requires hospitals to provide emergency care to patients who need it whether or not they sign the hospital’s financial consent form, which hospitals try as explained above to bundle in with that consent form. All that you are required to consent to is appropriate treatment, and you are doing that with your own form without agreeing to take responsibility for any and all charges you might receive which might expose your wallet to unlimited plunder. By using your own form as recommended here, you are, in legal terms, entering into an open ended contract in which no price has been agreed upon before treatment. Your ER medical provider and/or the clerk at the ER reception desk would be unable in any event to tell you before examination and diagnosis what those costs are. In the case of open ended contracts such as you have, which are agreements that do not specify an exact price, the Uniform Commercial Code dictates that costs when articulated after contract signing must meet the standard of being “fair and reasonable”. Medicare payment schedules constitute the gold standard for fair pricing. If the ER bill that you later receive comes in at an exorbitant price which you dispute, you will be able to show in court or to an arbitrator or to any debt collector who pursues you that you made a reasonable offer of payment at the very beginning of your interaction with your provider via this customized “homemade” authorization. Even if you are forced to sign the hospital form before ER treatment, in the remote possibility that ignorant hospital personnel threaten to withhold treatment unless you sign their form, you preserve your right to argue later than you signed it unwillingly, under duress when you were too ill to do otherwise. Any contract that you are thus forced to sign is called a contract of adhesion and if you raise that adhesion issue defensively against any subsequent medical bill collectors, no court will award judgment for that debt collection, provided you observe all the bill collection dispute deadlines detailed elsewhere on this website.