Before we consider how we can minimize our emergency room costs we need to understand WHY emergency room cost is so high and indeed why there are such wide variations. We can then consider WHAT we can do lessen the number of visits we and our dependents make. If we must visit the emergency room HOW can we keep our costs to a minimum?
Are there alternatives?
First WHY?
The word EMERGENCY says it all! Emergency Rooms are designed to handle emergencies and from the moment a caller rings 911 for an ambulance or arrives unexpectedly on the doorstep the emphasis is on speed and the availability of expert staff and possibly $ millions worth of highly specialised medical equipment.
Let’s say that you have a traumatic wound, broken bones, significant burns or, severe heart palpitations, then, of course, these are the services you may need and can be justified. But they come at a price!
The average an ER visit cost is $ 1230 (NIH study) although some expert put it as high as $2100
Secondly What?
What can we do to reduce the number of visits to the emergency room?
Nobody invites or expects life-affecting traumas but when they do occur 911 and ER may be the right but most expensive option
In an emergency 911 is the number that comes to mind. It why almost 70% of calls to ER could be avoided. “I didn’t know who else to call” is the most common response,
Some Suggestions
Does your physician’s office number come to mind as easily as 911?
Do you know the number (address) of your nearest Urgent Call Clinic?
Do you know which of your local hospitals is ‘in-network’
KEEP THIS INFORMATION TO HAND (on your phone!) but
Don’t Think Twice- Go to ER or Call 911
FOR ANY OF THE FOLLOWING
Do you know the number (address) of your nearest Urgent Call Clinic?
Broken bones
Deep cuts/Profuse bleeding
New-born/ infant <3 months
Temperature >100.4
Sudden testicular pain
Vaginal bleeding when pregnant
Severe Heart palpitations
Severe breathing difficulty
Significant burns
Fever over 105 or fever with rash
Events like these usually leave no alternative to the emergency room.
HOW can we be sure that we are getting ‘best value’ from our insurance?
First check that the facility, the hospital, to which the patient is being delivered is ‘in-network’. Be aware that you can find ‘out of network’ Doctors and other service providers that work at in ‘in-network’ facilities. They may charge separately!
This can be especially true of the ambulance service that transports the insured to hospital. An ‘out of network’ service might charge $2000 or more, depending on where you live and the level of care delivered at the scene or on the journey.
THE ALTERNATIVES
A smaller, but far more common group of conditions includes the following:
Flu or cough
Severe headache
Ear infection
Diarrhea
Fever (without rash)
Minor trauma
You should not need to attend ER for these conditions. Don’t wait to be an ‘emergency’
Talk to your Doctor. Even if it’s out of hours there will be a Doctor to help you 24/7
OR VISIT YOUR NEIGHBOURHOOD URGENT CARE CLINIC
Many of these clinics accept health insurance, but not all. Check with your insurer. Even if not ‘in-network’ you may find the cost is far less than an emergency room cost and any resulting co-payments you might incur. Based on national averages an emergency room visit cost can be 3X greater than for the same treatment at an urgent care clinic.
PLAN FOR THE UNEXPECTED
Here are two suggestions
Check if your Doctor offers Telehealth which gives you personal access to a physician 24/7 from your phone wherever you are.
There are Mobile Apps which offer useful guides based on ‘easy to use’ decision trees to help the enquirer decide if an ER visit is the best choice. Ideal for dependents ‘away from home’.
Finally, Open enrollment is from November 1 to December 15th for your 2020 coverage. Now is the ideal time to consider how your health insurance needs may have changed in the last year.
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