They have to treat you in the E.R. but he said he didn't complete the process which is why he got charged. I worked in the E.R. for years and we saw this every day. Someone has to pay the bills. In California many small hospitals have had to close because folks just don't bother to follow up and they don't get paid for the services which the the hospital in turn has to pay. Supplies and staff don't come cheap these days. That being said you need to get it checked out somehow, even if you have to return to the E.R. to do it. They should still see you and if they do follow up so you don't get billed again.