How Misinformation Prevents the Benefits of Freestanding Emergency Centers

How Misinformation Prevents the Benefits of Freestanding Emergency Centers

The rising healthcare costs are increasingly becoming a headache for citizens, lawmakers, healthcare providers and health insurance providers. Out-of-network healthcare and surprise billing are some of the major problems that the United States is struggling with. Freestanding emergency rooms have been proven to be quite effective and a possible solution to the problem of inaccessibility of healthcare, particularly for people in the rural areas. However, they have been the main target and have been blamed by insurance companies as being the main factor contributing to the rising costs of healthcare.

Freestanding Emergency Centers have grown in number in the last few years. Thanks to that and their increased popularity, more patients can easily access medical care and more conveniently as compared to emergency rooms in hospitals. But the growth has also resulted in misinformation from insurance companies. Bellaire ER argues that the amount of misinformation with regards to freestanding emergency centers ultimately clouds the loads of benefits that these facilities bring.

When you hear the view of a health insurance company, they will say that Freestanding Emergency Centers prefer to remain out-of-network for their own benefits. This is one of the lies that cloud them since freestanding emergency centers have always been open to contract insurance companies. They are often denied when it comes to negotiating their network status to in-network. The few that are lucky to gain the in-network status are usually offered rates that are considerably low as compared to what other licensed emergency facilities are offered.

Consumers are usually on the receiving end when it comes to the consequences of the greed of insurance companies. The freestanding emergency companies require the patients’ treatment bills to be paid for them to be operational. However, since health insurance companies want to ensure that they make bigger profits, much of the medical costs are channeled to the consumers. That is how patients end up with surprise medical bills.

Over the last five years, insurance premiums have increased by almost 20 percent and deductibles by over 60 percent. The same span was characterized by an inflation rate of only 6 percent. This shows the extent by which insurance companies have shifted their focus from ensuring that Americans receive affordable healthcare to generating maximum profits. The huge resistance to keep freestanding emergency centers in-network, increasing the deductibles and the predatory low reimbursements, have resulted in shifting of healthcare costs to the patients.

The federal law and the state law require insurance companies to pay the full in-network benefits for all licensed emergency rooms in the state. This is to be done regardless of whether or not the emergency room has been contracted with the insurer. However, insurers often go against these laws by processing freestanding emergency center claims at out-of-network rates. The result is that policyholders end up being inhibited from accessing their full coverage. The consequent result is higher patient responsibility in the form of a surprise bill. A patient seeking an explanation for the same will always be hit with the false excuse that the cost comes as a result of increase billing by the healthcare providers while the truth is that they have cut their coverage for profit purposes.

Another misinformation from the side of health insurance companies is that freestanding emergency centers confuse their patients with regards to the offered services. Again, this is just a blanket they use to cover the fact that they are driven by the desire to create profits as opposed to providing efficient health care coverage to their customers. The good thing now is that laws are being put in place to prevent this kind of misinformation. In Texas, the law requires freestanding emergency centers to post signage inside and outside of their buildings that clearly state that they are emergency facilities. Additionally, patients have to provide written acknowledgment of the same. This law has yielded very positive results. The Texas Department of Insurance has been receiving fewer insurance coverage complaints.

When the model of freestanding emergency centers was introduced into the United States healthcare system, there was a lot of excitement and optimism that the freestanding emergency centers would help in solving the health crisis in the country. The model helps make emergency health care more accessible to the citizens, especially those in the rural areas, helps reduce the pressure that full-service hospitals are subjected to and saves thousands of dollars of medical expenses since they admit patients at a much lower rate.

However, insurance companies have come to take advantage of the nonexistence of clear guidelines to govern the existing laws. Their focus has always been to make more profits resulting in the derailment of this innovative model of providing emergency care to patients. As such, it is important that lawmakers make it their priority to establish clear laws and guidelines that will ensure oversight of insurance companies. Otherwise, the potential benefits that freestanding emergency care facilities provide will never be enjoyed.