Tag Archives: emergency room

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How to Find Medical Bill Errors

Senior man depressed by a pile of medical bills. Isolated on whMany people get medical bills from a hospital stay and don’t know what to look for to determine if the bill is correct. Here is some of the things you should look for:

  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!

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.

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Has ObamaCare Slowed ER Visits?

Doctor with female patientSurprisingly, 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. This is contrary to the goal of ObamaCare. What happened?

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!

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.

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Are You an Inpatient When You Are In the ER?

High angle view of doctor defibrillating male patient while nursNo. One of our readers, Bob, was very surprised with this answer. Bob was taken to the ER after a car accident. He was treated and released. Following his ER visit, Bob got many bills saying he had to pay for much of the cost himself. He wondered why since he had good hospital insurance coverage.

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.