Have you been to an ER lately? The cost and wait time are about as painful as the reason you’re there! According to a 2009 study, patients spent an average of four hours and seven minutes in an ER. I can only imagine where it’s gone from 2009 to 2014! And, you’re not supposed to LOSE an arm and a leg in an ER, but that’s about what it costs. According to one recent study, the average cost is $1,477.
We’re sharing a series about provider networks because they can affect your out-of-pocket expenses in a BIG way if you’re not aware of how they work.
**In-Network & Out-Of-Network explores what a network is and how it can impact you.
**Why Shrinking Networks? explores why today’s current insurance plans have less provider choices.
**Shrinking Networks - What Do I Do Now? gives tips for dealing with a smaller network of providers.
**Why Do I Have 2 Deductibles? explains how your two In-Network and Out-of-Network deductibles work and how they impact you.
Today, we’re continuing the series with some tips on how to navigate provider networks in a non-emergency vs. emergency situation.
Be sure it’s an emergency
Are you having heart attack symptoms OR do you just symptoms of an ear infection? Those are two totally different things – one qualifies as an “emergency” and the other doesn’t. If you’re going to an emergency room, it’s going to be expensive – it is, after all, the most technologically advanced room in your entire city! So be sure your illness is deserving of the attention and expense. It’s worth thousands of dollars to get it right!
But, how can you be sure? Click here for a handy recap of ER-worthy symptoms from health.com. You should also consider subscribing to a telemedicine service. These services provide 24/7 access to general practitioners, pediatricians, internists, etc. via phone, text, email, video. In most cases, you can contact them quickly for advice on best next steps based on your symptoms. The cost of having this type of service for your family is nominal considering the $1,500 bill you’ll pay for a bottle of Pepto if those stomach pains turn out to be a simple case of food poisoning!
Oh yeah, THAT’S an emergency!
Let’s say your condition qualified as a true emergency, you went to an ER and received the help you needed. A month later, you learn you were charged double the normal cost because your insurance company says it was an out-of-network provider. In some cases, this can be fixed with a call to your insurance company. After all, you were under anesthesia and couldn’t really ask which doctors were in-network on your plan! Click here for an article we recently wrote with some other advice on how to handle a medical billing situation like this.
In a non-emergency situation
If you’re considering a non-emergency procedure, ALWAYS shop around! Granted, this can be a time consuming and confusing job, but it’s usually worth the savings. And, there are services that can help. These type of companies can also help organize an entire procedure to make sure all the providers are in your network (and you’re not surprised by a random out-of-network medical bill), find the best priced facilities, schedule appointments, etc. Again, the cost of having this type of service for your family is nominal considering the savings of not only money, but time and frustration.
Here’s a story from someone who recently used an advocacy company to get local pricing on a common procedure: “I needed an MRI and knew the prices varied wildly from location to location. I called and asked them to do some research in my local area. I received an email with 3 different locations and the pricing for each. The prices varied from $450 to over $1000, so I'm really glad I called to get the info before blindly walking into the higher priced location!”
Now it’s your turn! Have you ever been saddled with a big ER bill and wished you’d made a different choice in care? Have you ever received an out-of-network bill from a procedure when you were in a morphine-induced state?