How to Minimize Your Emergency Care Expenses

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EnjoyIt
Posts: 5862
Joined: Sun Dec 29, 2013 8:06 pm

Re: How to Minimize Your Emergency Care Expenses

Post by EnjoyIt »

Paul78 wrote: Thu Dec 10, 2020 7:34 pm
StevieG72 wrote: Sat Jan 20, 2018 6:53 am Thanks for posting, great information.

Side note, it seems that anytime and everytime I call the ask a nurse type service they direct me to go to the ER.
Well if you say any of the keys words the nurse is always going to recommend the ER... Your life is on the line and their license/job is on the line. So of course if you say anything that "might" be serious/critical they will advise ER. The nurse hotline is really more for triage (ie follow up with PCP, go to urgent care, go to ER) so people with a scraped knee don't go to the ER.
If I got $100 for every time I saw a patient sent in by a primary care doctor’s office for something they could have and should have taken care of in the office, I would be a millionaire.
A time to EVALUATE your jitters: | viewtopic.php?p=1139732#p1139732
Francis42
Posts: 51
Joined: Wed Feb 19, 2020 12:27 am

Re: How to Minimize Your Emergency Care Expenses

Post by Francis42 »

A part of my job is negotiating contracts with hospitals, primary care physician, and specialists. After renegotiating 4 hospital contracts last year, I can tell you - hospitals are what’s wrong with healthcare. Spend a few minutes looking up Prem Reddy and Prime Healthcare and you’ll get what I mean real quick.
Francis42
Posts: 51
Joined: Wed Feb 19, 2020 12:27 am

Re: How to Minimize Your Emergency Care Expenses

Post by Francis42 »

EnjoyIt wrote: Thu Dec 10, 2020 9:46 pm
Paul78 wrote: Thu Dec 10, 2020 7:34 pm
StevieG72 wrote: Sat Jan 20, 2018 6:53 am Thanks for posting, great information.

Side note, it seems that anytime and everytime I call the ask a nurse type service they direct me to go to the ER.
Well if you say any of the keys words the nurse is always going to recommend the ER... Your life is on the line and their license/job is on the line. So of course if you say anything that "might" be serious/critical they will advise ER. The nurse hotline is really more for triage (ie follow up with PCP, go to urgent care, go to ER) so people with a scraped knee don't go to the ER.
If I got $100 for every time I saw a patient sent in by a primary care doctor’s office for something they could have and should have taken care of in the office, I would be a millionaire.
I’ve seen them sent to the ED by the PCP when they could have been treated in the office very easily. Only the PCPs bill fee for service and needed the room back to see mo’ patients!
Den111
Posts: 20
Joined: Wed Apr 21, 2021 7:35 am

Re: How to Minimize Your Emergency Care Expenses

Post by Den111 »

In the past some emergency room doctors were not contracted with insurance companies and therefore were able to bill hugely exorbitant rates.
I understand there was legislation that was going to fix the issue.. Did that ever happen.
trueblueky
Posts: 2142
Joined: Tue May 27, 2014 3:50 pm

Re: How to Minimize Your Emergency Care Expenses

Post by trueblueky »

Den111 wrote: Sun May 09, 2021 12:34 pm In the past some emergency room doctors were not contracted with insurance companies and therefore were able to bill hugely exorbitant rates.
I understand there was legislation that was going to fix the issue.. Did that ever happen.
The No Surprises Act passed December 27, 2020. Parts take effect in 2022.

At www.aha.org, type No Surprises in the search box.
Den111
Posts: 20
Joined: Wed Apr 21, 2021 7:35 am

Re: How to Minimize Your Emergency Care Expenses

Post by Den111 »

Thanks I read this highlight on the AMA site

"Protects patients from receiving
surprise medical bills resulting from
gaps in coverage for emergency
services and certain services
provided by out-of-network
clinicians at in-network facilities,
including by air ambulances."

Not sure what that means.. Does that cover an actual case where a patient with very severe injury arrives by ambulance at a hospital that is contracted with for example blue cross and is treated by an emergency room doctor/surgeon that is not an in-network provider with blue cross . The bill for the surgeon was in the 40 to 50 thousand dollar range. After the patient was released about a month later the very large hospital and various doctor bills were paid by blue cross except the surgeon bill. The surgeons "billing company" started threating the patient with all kinds of recovery actions" The patient was a college student and over the age of 21 with no resources so the dr got nothing from the patient other than what he could negotiate with B.Cross. . Had the the individual been a minor the parents would have been liable. That is the situation that needs to be fixed. I hope the "no surprise bill" that takes effect soon does it.
RetiredInTheWest
Posts: 56
Joined: Mon Nov 27, 2017 10:43 pm

Re: How to Minimize Your Emergency Care Expenses

Post by RetiredInTheWest »

This was a very useful and interesting post - shared with family members. A big thanks to the OP!
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