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October 23, 2018

Emergency Room Questions: What If I Have Questions about My Bills

Emergency Room Questions: What If I Have Questions about My Bills

Each time you visit a doctor or go to an emergency room, you will always get a bill when you leave. Sometimes you may not be impressed with the invoice that you get; because like any other service, mistakes can occur during the preparation of your invoice.

When this happens, you should be ready to speak up to, in order to understand how you got billed and for which services. FrontLine ER would like to discuss the billing procedure to help address any issues you may experience, plus tips on what to do if you feel the bill isn’t correct.

The Process

During your visit to FrontLine ER, you will always be asked to fill in some forms with all your health insurance details. A copy of your insurance card is taken and filed together with the completed form.

So, what happens next?  It is at this point that most people leave it as it is, without any slightest idea of what happens afterward.

First, the billing staff will file a health insurance claim. A health insurance claim is a bill to your health insurance provider for any medical services you or a covered member of the family receives. The company agrees to pay the request based on the benefit coverage.

Usually, you will be required to pay a standard amount (co-pay) or a certain percentage of the claim. It means that you only pay a small part of the medical bill from your pocket and the insurance covers the rest.

The insurer provides a cover for all ER visits. When you have a medical emergency, the insurer is legally required to pay for any costs for your ER expenses. It doesn’t matter which ER you visit. You can seek medical care wherever you choose. The insurance provider is obliged to honor your out-of-network benefits for your ER visit.

Next, when you have now completed the paperwork for admission to the ER, you will now be required to pay your insurance policy’s co-pay.  Ask the registration clerk about the billing options offered at the ER.

FrontLine ER accepts all in-network rates, even if they aren’t part of your health insurance coverage network. .They also take in patients who prefer to pay in cash, credit card or cashier’s check. For those who do not have insurance, we shall work together to draft a payment plan that will help you cover your visit.

Whichever the case, check with our billing team will help you understand your options and provide an estimate of the services to help you make a comparison. Once you know your options, it can help reduce the total claim made by the insurer.

The Explanation of Benefits (EOB)

The moment you walk out of the ER, you will receive an explanation of benefits (EOB) in your mail.  The EOB will list all the services you had received since the moment you checked in at the emergency room and their costs.

It is imperative to note that, this is not the bill. Front Line ER explains it as a document that the ER uses to generate a claim for your insurance provider. Through the EOB, the insurance company can know what amount they are required to pay. If there is an extra amount, you should be ready to pay out of pocket.

You May Receive Separate Bills from Emergency Room Departments

Emergency rooms attached to the hospital often rely on the hospital for technical resources. You should expect separate billing because legally, they are separate entities. For instance, if you came to the ER and had laboratory tests and an x-ray,  you may receive the bill from the hospital itself for technical resources, an invoice from the ER physician, one from the radiologist for interpreting the x-rays, and another from a  pathologist for analyzing any specimens taken.

However, if you visit a standalone ER such as FrontLine ER, you will eliminate all issues of multiple claims. The billing team will charge for any services taken as part of your facility bill. Combining the statements help to speed up the process of a claim.

How to Deal With Surprise Bills

You may have visited the ER for what seemed like a minor issue. However, you end up receiving a bill worth thousands of dollars and you are required to pay. So what can you do?

First things first, check the bill carefully. If possible, request for an itemized bill which will detail all the services and the charges on each one of them. Look for duplicate costs, canceled tests or drugs, medical terms you do not understand and any fees for procedures you may have declined. Research shows that about 80% of all ER bills come with errors especially when you happen to visit during hectic hours. 

 

Next, after scrutiny, you should make a complaint with the billing team at the ER. They are in a better position to review your statement and audit the bill. Also, it’s good to confirm if your insurance provider has received and processed the claim. If not, contact them to verify if the coverage status of services and procedures.

Emergency Care, Emergency Room