How Emergency Room Visits are Billed

How Emergency Room Visits are Billed

The charges of emergency room services may seem incredibly high, even for simple operations. If you are living in America, the charges may even seem more exaggerated, as it is estimated that emergency rooms in America charge an average of three times higher than emergency rooms from other developed nations around the world. Emergency room bills are usually sent to the patients weeks later after treatment, which makes many patients feel that their bills may have been wrongly quoted. However, understanding how the emergency rooms are billed can help remove much of the confusion that many patients go through.

Patients who visit emergency rooms are required to fill out certain forms that provide the information about their health insurance details, and how they expect to fund the bills. Usually, your card is filed together with the forms that you had filled out before, and then the charges are billed from your insurance. Most times, the bill given is higher than what you would have paid had you been treated at a regular hospital. Here are few reasons why the total may appear so high:

To cover for the uninsured patients

Did you know that you would still receive emergency treatment even if you did not have an insurance cover? All people in the United States are entitled to receive emergency medical care regardless of whether they have insurance cover or not. There are several reasons why one may not be insured. For instance, many people are underprivileged, thus cannot afford a health insurance to cover for their emergency room benefits. Hospitals, therefore, set up high gross charges to those who already have insurance covers to cater for the expenses of those who cannot afford to pay. This is why your emergency cover charges may appear higher than what you had expected.

To give room for bargaining with the insurer

You emergency room bills may appear incredibly high, but did you know that your health insurer usually ends up paying much less than the amount quoted on your bill? You may not have known this, but insurers are adept at contract negotiation. The emergency room agency thus sets up a higher price to give room for bargaining with the insurer and end up with a sum that covers for your actual medical bills. Moreover, remember from that out of the final amount that the insurer is willing to pay, depending on the agreement you have with your health insurer, you will still repay a certain amount back to them. Therefore, your hospital must set an amount on your bill that gives room not just for negotiation with your insurer, but also for the further deduction that will be repaid to the insurance company.

You pay for every single charge provided by the emergency room

Depending on the medical care you receive, your bill may seem unexpectedly high. Emergency rooms charge for every single service that they offer, even for those seemingly minor services such as an MRI scan. Each department in the hospital whose services you use gives a separate quotation that you will be expected to pay. These different quotations are then totaled to come up with a final amount. Many emergency room agencies have many different departments that operate as separate legal entities with different managements, which may contribute to the large bill you see at the end. Some agencies like Bellaire ER, however, have very few departments. Thus your bills are relatively likely to be lower compared to other emergency rooms.

The severity of condition determines how much you will be required to pay

Emergency rooms do not just charge for every service they offer, but also attach an amount equivalent to the severity of your condition. Depending on how complicated your treatment will be, your bill will vary. Emergency rooms have varying levels of care with the first level catering for simple conditions such as toothaches and the complexity of treatment going up the ladder. Simple medical procedures attract relatively lower bills while those on the highest level of care attract significantly higher charges.

The emergency room you chose matters

Different emergency room agencies charge differently for their services. Attending an expensive emergency room will attract higher bills, while an affordable emergency room such as Bellaire ER provides the highest quality urgent medical care at customer friendly rates. Their emergency rooms are equipped with the latest equipment while their staff has immense experience in attending patients with urgent medical needs. Moreover, Bellaire accept health insurance cards from a wide variety of insurance companies in the United States, which makes it very convenient for patients living there.

Virtually everyone in the United States with a health insurance cover is eligible for emergency room services from a provider of their choice. All American health insurers provide this critical benefit to its customers. Therefore, it is your right to acquire health care benefits at any time you or your loved one are hit by any of the wide variety of health conditions that may warrant urgent health care. If you are a resident of Houston, walk into any one of the Bellaire Emergency Room providers to sample the different services on offer for you.