Knowing The Cost Of an ER Visit

Not knowing the cost of an ER visit at the time of service is indeed frustrating. It’s frustrating for you, the patient, and for The Emergency Center. Ideally, we would love to be able to tell you how much it costs to treat a specific complaint. Unfortunately, it’s not that simple.

Some of our patients have told us they find it helpful to learn that each complaint is not equal. To lay some groundwork and provide greater transparency, let’s walk through an example. One of the common complaints we receive is chest pain. If you come in and tell us you have chest pain, it may simply be acid reflux that medication could take care of. However, it could also be a life-threatening heart attack which requires surgery. Both have the same complaint, however, until the doctor sees you, conducts an examination and gets appropriate tests, there is no way of knowing what the cause is, and therefore, what is needed to keep you safe. Both patients will start with an initial exam and potentially even the same initial tests to help determine the cause of the chest pain. But depending on the results of the exam and each one of the tests, the course of treatment and additional tests ordered could vary drastically. At the time of the initial complaint, there is no way for the staff, or even the doctor, to know what may be needed to ensure your medical condition is treated in the best possible way to help you return to health as quickly as possible. The human body is so complex that making an estimate before performing a complete exam would be irresponsible and unfair to you.

Be Prepared, Know How Your Insurance Works

Another thing that makes estimating charges prior to receiving services impossible is insurance. After all the diagnostic and treatment work is completed, the chart and bills are sent to your insurance company. Your insurance company reviews the charges and agrees to pay what it considers a reasonable and fair amount. The Emergency Center will typically accept the reasonable and fair amount determined by your insurance company and will not require you to pay any amount over that. However, the portion of the amount you are responsible for paying can also vary dramatically. There are thousands of insurance plans and, unfortunately, they are not all alike. Because of this complexity, you may have a copay, a deductible (that you may or may not have met), coinsurance, or none of the above. It is impossible for any medical facility to know what you and your insurance company have agreed on.

The bottom line with insurance is that the amount you may owe greatly depends on what your insurance company approves and the type of insurance plan you chose. Unfortunately, in an emergency setting, there is no way a provider can know all this unique information before service begins.

We share your frustration with this process. That is why we are committed to helping you work through the insurance process to make sure your bill is processed appropriately. Some patients who had billing concerns found it helpful to study their insurance plans carefully and ask their insurers for more information to avoid surprises. Unfortunately, for now, the billing process described above is the same at every emergency facility. We would simplify the billing process for you, and all our patients, if that were possible. While that is not possible right now, what is possible is to ensure you have the best experience while you are at The Emergency Center. And so, until there is a better way to manage billing for emergency situations, we have committed ourselves to providing the fastest, friendliest, highest quality and most comfortable emergency experience possible because you, your time, and your health are our highest priority. If you would like to discuss your bill or need help working with your insurance company, please call us at (817) 554-8553.