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The post What You Need to Know Before Going to the Hospital appeared first on MyHealthSpin.

In this short video, I talk about what to consider if you are unsure of whether or not you need an emergency room. Watch it now—before an emergency arises—so you’ll be prepared if something does happen.

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The post Should You Go to the Emergency Room? appeared first on MyHealthSpin.

Something has happened. Perhaps a loved one fell ill suddenly or just plain fell and got injured. Should you rush to the emergency room? Should you wait until your doctor’s office is open in the morning? 

If you rush to the emergency room, but it turns out to have been something that could wait, you might be out a lot of money in unnecessary medical bills. But if you wait until morning, the issue might become more serious.

How do you know whether to go to the emergency room or to your doctor during regular office hours? This video will help you decide. 

The post Emergency Room or Wait? appeared first on MyHealthSpin.

Many people get medical bills from a hospital stay and don’t know what to look for to determine if the bill is correct

1. No “Balance Billing”: You should make sure that if you went to a doctor who is in your “network,” you should not receive a charge for the visit (other than a possible co-pay). When the doctor charges you the difference between their normal charge and what the insurance company will pay for the service, this is called “balance billing.” You should not get a bill from the doctor if you went to doctor who was “in network.”
2. Check Quantity: If you were in the hospital, you will want to check the quantity of items and services you are being billed for. For example, look at medications and the amount of days you were in the hospital. Hospital billing departments often make mistakes.
3. Duplicate Charges: Make sure you were not billed twice for a procedure or a lab test.
4. Upcoding: Many healthcare services have levels of care. For example, you can go to the ER for something simple – which should be billed at the lowest level of care or for something very complex – which will be billed at the highest level of care. You should look at the bill to see what was charged.

Looking closely at your bill can save you money.

Tell us whether you have had any problems with your medical bills? We’d love to hear from you!

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Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post How to Find Medical Bill Errors appeared first on MyHealthSpin.

Surprisingly, no. Most hospitals report that ER visits are on the rise. Three quarters of ER doctors report that since ObamaCare has been in effect the ER is seeing more patients than ever before.

There are a lot of different answers.

1. People have insurance but there are not enough primary care doctors to see them.
2. ObamaCare expanded Medicaid and many primary care doctors won’t accept Medicaid due to its low reimbursement.
3. The newly insured cannot take off work to see a primary care doctor or lack transportation or child care. (Source: USA Today Article)

All of these factors make the ER often the best or only option.

Should you use the ER for your healthcare? Not if you can avoid it.

1. Call your insurance company and ask for a recommendation to a primary care physician. If you have a Medicaid HMO, a primary care physician will be assigned to you.
2. Schedule your first appointment when you are not sick. It is important to establish a relationship with your doctor BEFORE you are so sick that you get referred to the ER.
3. Pick a doctor who has late night or weekend hours if you can’t miss work during the week. Many physicians are now offering more convenient appointment times.
4. Be proactive and take responsibility for your healthcare. It’s the only way to stay healthy and avoid expensive ER visits.

Have you ever gone to the ER and wished later that you had not? I’d love to hear from you!

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Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post Has ObamaCare Slowed ER Visits? appeared first on MyHealthSpin.

No. One of our readers, Bob, was very surprised with this answer.

I explained to Bob that insurance companies consider the ER an outpatient service. Your insurance often covers less of the cost of outpatient services than inpatient services. This is confusing since the ER is usually in the hospital.

Additionally, there are often many people who see you in the ER who will each likely send you a separate bill. The ER physician may send you a bill. You may get a bill from the radiologist who read your x-ray. You will also get a bill from the hospital for all the services you received in the ER. Since these are all outpatient services, you will likely have to pay for many of the costs out-of-pocket.

The average cost of an ER visit is approximately $1,265. It can cost a lot more depending on the seriousness of the visit and which tests are run.

If you are admitted to the hospital, the ER charges are often included in the hospital bill. However, if you are like Bob and you are sent home, you may be responsible for a large part of the bill.

Do you have any questions about your health insurance coverage? I’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post Are You an Inpatient When You Are In the ER? appeared first on MyHealthSpin.

This is a question Laura asked me this week. The answer is “talk to the ER doctor.”  

Laura explained to me that her dad wasn’t feeling well last month so she took him to the ER. The hospital held Laura’s Dad in the ER for several days. The room Laura’s Dad was in looked like a normal hospital room and she thought he was admitted to the hospital. However, as it turns out, he was actually in “observation.”

Observation means the physician is trying to decide whether the patient needs to be admitted to the hospital or can go home. The only way to know whether Laura’s dad was “admitted” or in “observation” was to ask. The hospital is not required to tell the patient that they are in observation. Medicare recommends that “observation” be limited to 24-48 hours, however, some hospitals keep patients in “observation” for much longer.

Laura and her dad found out why “observation” can be a problem. Laura’s Dad was referred to a rehabilitation facility upon leaving the ER. For many services like inpatient rehabilitation, you must have been admitted to the hospital for a certain period of time for your insurance to cover the service. Many insurance plans only cover rehabilitation facilities after a certain amount of time as an inpatient in the hospital. For example, you might need to be in the hospital for 3 days prior to being admitted to an inpatient rehabilitation facility for your insurance to cover the rehabilitation costs. If you were in “observation” for 3 days, that will not meet the requirements by your insurance company.

How do you avoid this problem?

1. Talk to your doctor and ask whether you are admitted or in observation.
2. If you think you must go from the ER to another care facility, ask the hospital whether it is necessary to be admitted into the hospital to get coverage.
3. If you find out you are in observation, insist on being admitted if it is necessary to stay in the hospital.

Have you ever been placed in “observation” in the ER? How long did it last? I’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post How Can I Avoid ER “Observation?” appeared first on MyHealthSpin.

Call any doctor’s office and you’re likely to hear a message like this: “If you are getting this message and need medical attention, call 911 and go to the nearest ER.” Should you follow this advice? Not always.

The ER can be very expensive, time consuming and not always the best place to go for basic medical care.

There are some basic Dos and Don’ts when it comes to the ER.

DO go to the ER when:

1. You have a life threatening problem, such as a heart attack, stroke, etc.
2. You were in a serious accident.
3. You are unconscious.
4. You are bleeding heavily or are in excessive pain.
5. You have been directed to do so by your doctor.

It is important to understand that the ER is intended to take care of severely sick people. The hospital will determine who in the ER is the sickest and take those people first. So if you go to the ER for basic medical care you will likely be waiting a long time. Often you will wait only to be seen and told to go to your own doctor the next day. If this happens, you have paid a lot of money for an expensive ER visit when you could have just waited until your doctor opened in the morning. 

So when should you skip the ER?

DON’T go to the ER when:

1. You have a basic cold or virus.
2. You need to see a specialist, but it is not urgent.
3. You need to see your doctor – it’s not likely your doctor will come to the ER.
4. You need to get a test which is not urgent.
5. You can wait until your doctor’s office opens in the morning.

Have you ever gone to the ER and wished later that you had not? I’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post 5 Dos and Don’ts of Using the ER appeared first on MyHealthSpin.

Need to go into the hospital, but your problem isn’t life threatening?  Instead of sitting for hours in the emergency room, work with your doctor to be directly admitted.

Many patients don’t know they can bypass the emergency room and be directly admitted to the hospital.  Most people use the ER as the entry point for a stay at the hospital.  Some are in a truly life-threatening situation where minutes count so they’re in the right place. But many have an ongoing condition, such as congestive heart failure or diabetes, that sometimes requires them to spend time in the hospital.  In those cases, hospitals may allow their doctors to directly admit patients to a hospital room, saving everyone time and money.

The emergency room is designed for emergencies.  The ER quickly evaluates (triages) every patient to determine how fast he or she needs care.  If you have an ongoing problem that isn’t life threatening, you will generally wait a long time to get any further attention.  This can be very frustrating for patients who know they’ll be admitted but must wait for the ER staff to first treat real emergencies (gunshot wounds, heart attacks, etc).  It will often take them a long time to get  a doctor on staff at the hospital to see you.  If it’s after hours or on the weekend, the hospital doctor will often know nothing about your history.  So, he or she may then run a bunch of tests to figure out what your problem is. But, if you talk to your primary care doctor or specialist  in advance, you may be able to avoid this hassle.

If you have a doctor who regularly sees you for your healthcare needs, it’s much better to have that doctor determine what you need and when you should be hospitalized since they know your medical history.

The way to avoid wasting time in the emergency room is to talk to your doctor ahead of time.

You should ask your doctor:

1. What hospital your doctor goes to.
2. Does that hospital have a direct admit policy.
3. If your doctor thinks you should be in the hospital, ask if he or she will write an order to have you directly admitted to a room.
4. Find out what days of the week and times of day the hospital accepts direct admissions.

Having this discussion with your doctor in advance will save you the time and expense of having to sit in the emergency room for hours when you know you need to be admitted to the hospital.

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