High and surprise hospital bills are nothing new. Just look at some news headlines or do a quick Google check and easily find articles or blogs like:
How then do you avoid high or surprise bills from the ER?
Needing to go the Emergency Room (ER) is a difficult situation to be in as you are in some sort of medical emergency and that’s all you can think about. You or your loved one's health is the absolutely the most important thing. Unfortunately, the average ER visit bill is $3000 or more.
Here are some quick tips that may help reduce super-high ER bills, or at least when you get the bill, you will know beforehand:
1) Know which ERs are in your insurance network—Contact your insurance company and find out which ERs your insurance company covers. That way if an emergency comes, you will not have to think about which ER to go to. There was a recent news story about a woman in an emergency who was insured, but was transported to the wrong hospital which wasn’t in her network. If she had known which ER she was covered in, she might have directed the paramedics to take her there.
2) Out-of-Network Doctors in the ER and Balance-Billing—Another problem people run into is that they go to the ER that is in their insurance network, but then get slammed with a high ER bill anyway. What sometimes happens in these cases is even though the ER is in network, some of the doctors working at the time you are there are not, so they bill at their regular rate, which may be well above what your insurance pays to them.
This is called balance-billing. They then submit their bill and ask for the balance of their bill, directly from you. Several states have addressed this balance-billing issue for ERs. California and several other states restrict this practice for out-of-network providers.
See this list to find if your state has a law protecting patients against balance-billing and look to the ‘ER services' column: http://kff.org/private-insurance/state-indicator/state-restriction-against-providers-balance-billing-managed-care-enrollees/
3) Keep your wits and READ everything—This is obviously easier said than done, especially if you are in an emergency situation. The last thing you want to think about is money or how you are paying for the bill in this situation. If it’s a rapid or fluid situation, the ER personnel will be presenting a lot of papers for you to sign. Please try to read everything. And if there is something your don’t understand, please ask. It is your right to be fully informed of what you are signing.
I have an analogy for this situation: you wouldn’t walk to a car dealership and agree to buy a car without them telling you what you are buying and what the terms are, would you?
A hospital form that you sign isn’t just a run-of-the-mill form you just sign. It’s a binding fee for service contract. Once you sign it, you are bound to its terms. That is, if you agree to payment within it, you must pay.
If you don’t understand something in it, ask the nurse or ER personnel what the term in the form meant. If they don’t understand what the ER contract form means, ask them to find someone who can tell you what it’s for. If you still don’t understand or if it’s not explained to you, then you may want to move on to my next tip.
4) Strike or line out the forms—You have the legal right to remove terms from the ER contract by physically striking or lining them out with your pen. Simply, this means that you are not agreeing to that the term struck or lined out, which means you may not obligated for that term.
Be careful, because striking out or not agreeing to terms runs both ways, meaning the ER then is not obligated to give you a service, which in an emergency situation is tricky.
5) Don't be bullied--Most everyone at the ER will be useful and helpful to you. Unfortunately, like every workplace, you will meet some bad players. These particular people may try to force or bully you to sign something that you don't understand. They may not even realize that's what they are doing. Don't be bullied into signing anything you don't understand. It's your right to be informed and stand up for yourself.
6) Get an estimate--Some states require that hospitals give you an estimate of the regular hospital bill. Almost all states are required to give you a line item bill. While it's not clear whether ERs are obligated to give you an estimate of charges beforehand, see if you can get one, or see if they will tell you how much each service provided will cost before they do something.
7) Go to an Urgent Care Center instead of the ER--If you are not in a dire situation and feel safe enough to go to an Urgent Care Center instead of the ER, then do that. Frequently, urgent care will be less expensive than an ER. Again, be cautious though, as they could possibly have high rates too. The best thing to become familiar with the Urgent Care Centers around your areas. Call around your area and find out what their rates are. Knowledge is power.
Overall, being in an emergency situation is difficult and going to the ER is a last option. Obviously you or your loved one's health is the absolutely the most important thing, but if you have to go, PLAN AHEAD, ASK QUESTIONS, and DON'T BE BULLIED.
*Thank you ABC Reporter Nurse Michelle Katz for this topic!