Going to the Emergency Room May Result in a Surprise Out-of-Network Bill

Going to the emergency room often means having to endure long wait times, high stress levels, and an uncomfortable environment. A recent study found yet another reason to shy away from emergency room visits whenever possible.

Many patients go to hospitals that are in-network with their insurance plans, knowing this will keep their medical bill at a reasonable cost. However, the shocking reality is that even if you go to the emergency room at a hospital that is in-network, the emergency room physician attending to your care may not be in your network. What does this mean for patients? A shockingly high medical bill. And this occurs in roughly 2 in 10 emergency room visits, according to researchers at Yale University, Zack Cooper and Fiona Scott Morton.  

Hospitals often contract with physicians for their services, meaning that while the hospital may be in- network, the physician is not. When you are cared for by an out-of-network physician, your medical bill rises astronomically. The researchers estimated that patients may be responsible for an average balance of $622, following an emergency room visit.

According to a study by Truven Health Analytics, 71% of emergency room visits were found to be unnecessary. Avoid being another surprise bill victim by visiting your doctor for non-emergency issues instead of making a trip to the ER. Making this decision comes down to educating yourself.

•         Know the warning signs of serious conditions such as heart disease or stroke that warrant going to the emergency room
•         Make regular visits to your doctor and talk to them openly about any symptoms you may be feeling
•         Know which medical issues can be cared for at urgent care clinics such as common illnesses or minor injuries