There are many issues contributing to the dramatic rise in the cost of ER visits.
But one of the more prominent is the growing number of private contractors now operating the ER at your local hospital. Because they are not employees of the hospital, they use it as an opportunity to charge significantly more for your care and in some cases balance bill you for hundreds or thousands of dollars.
Three steps consumers can take to protect themselves from excessive out-of-network charges or surprise bills
There is safety in networks – Stay in network as often as you can. Many insurers offer a broad choice of local in-network health care professionals, and these in-network providers agree in advance to what they’ll charge for specific procedures, removing any guesswork or potential surprise bills. We understand that you cannot control when an out-of-network physician is practicing at an in-network hospital. If you find yourself in that situation and you’re balance billed by the physician, call us. We can help.
Research your expected costs – There are a number of tools available today, many as apps on your phone or tablet, that allow consumers to easily research the estimated price of specific treatments and procedures. UnitedHealthcare made its Health4Me app publicly available, so anyone – even non-UHC members – can research prices for specific physicians and hospitals in their community. A web site called FairHealth.orgOpens a new window also provides information on what the average cost is for specific procedures in your state.
Call your insurer – For non-emergency services, call before your procedure to verify the care providers are still in-network, and call again afterward if you receive a surprise balance bill. Some insurers, such as UnitedHealthcare, have service representatives who may be able to serve as an advocate on your behalf and negotiate with the physician to either lower their out of network charges or waive them all together. This is a particularly valuable resource in cases of emergency care, where a consumer has no control who is going to treat them in the ER even if the hospital is in network.