Tag Archives: emergency room

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How Can I Avoid ER “Observation?”

daughter hugging her fatherThis 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.

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5 Dos and Don’ts of Using the ER

Emergency Sign With Copy SpaceCall 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.

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Skip the Emergency Room Line

Doctor and Patient

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.