Here at The Patient Advocate Agency Private Healthcare Advocates, we get a lot of calls from people needing assistance after an emergency room (ER) visit. They need help understanding the stacks of bills they receive after receiving emergency services, or help figuring out what to do after being released to continue their care. Many people do not fully understand their diagnosis and treatment plan upon being discharged, which typically leads to some sort of lapse in their continuing care. According to the CDC in 2013, 130.4 million Americans visit the ER every year. That is about one third of the United States’ population! Because of the number of calls we get and people who visit the ER each year, we decided to come up with a few tips to know in the event you or someone you love has to go to the emergency room.
One of the most important things you can do while in the ER is speak up and ask questions if you do not understand what the medical staff is doing or telling you. Given the hustle and bustle and short interactions with staff, the environment can be very intimidating for even the most diligent of patients. Many people leave the ER confused or do not completely understand their situation, because they did not take the opportunity to clarify the situation and/or request an explicit plan going forward. For example, if you have a wound stitched by an emergency physician and it does not look like it was properly closed, it would be worth your while to state this to the doctor or attending nurse, worst case being that they take another look and determine that the situation is normal for the circumstance. OR, (because mistakes and missteps do indeed occur) they are compelled to take another pass at the procedure because of their reassessment brought on by your suggestion. Otherwise, you are going to leave with a wound that has not been properly sealed, which takes longer to heal, and most likely need to visit another doctor to fix it, costing even more money on top of the bill you receive from going to the ER. Doctors are not immune to scrutiny. It is okay to ask questions when it comes to your care. If you do not understand the diagnosis you receive in the ER, make sure to have your doctor clarify it so you do not end up coming right back. They are doctors, not mind readers, and you are their best source of information, so be honest and forthright with any additional information and questions that could be potentially pertinent to the situation at hand. The same goes for your treatment plan when leaving the ER. Make sure you know exactly what that plan is and what you need to do to follow up your care. Again, this will help prevent you from unnecessarily returning to the ER. And, I know it can be hard to remember everything that goes on during an ER visit, which is why it is really best to have someone there with you who can pay attention to everything going on.
After you visit the ER, you will typically get a few different medical bills; at least one bill from the hospital you visited, and one from the physician or physicians that treated you. There can be more than one physician bill of you also saw a specialist. Before you whip out your credit card and pay your bill, do your research and wait to receive all of your bills. If you only get one bill, that is great and your life will be a little bit easier. Either way, once you receive your bill, or bills, make sure to ask for an itemized bill and review them to make sure you do not get double charged for anything. Trust me, it happens more than you think. You should also receive an explanation of benefits (EOB) from you insurance explaining what your insurance covers. If something does not make sense, call your insurance company and have them clarify. The same thing goes for the bills you receive from the providers. After you have done your due diligence to make sure you are being billed correctly, then I would go ahead and pay the bill. Make sure to do this research in a timely manner so you do not get penalized for making a late payment.
Finally, if the situation permits, you can try to avoid going to the ER, if and only if it is unnecessary. A number of people visit the ER when they could have just gone to Urgent Care or sought advice from their treating physician first. It is best to establish a good working relationship with your primary care physician or treating physicians, so when you are unsure if something is an emergency, you can call them first. This is only in cases that are NOT life threatening, and you are trying to determine if you should or should not go to the ER. It is beneficial to have a patient advocate who can help establish a good relationship with your physician, as well as facilitate communication between you and them.
I hope some of these tips help the next time you find yourself headed to the ER, and if you need further assistance after your visit, give us a call! A patient advocate at The Patient Advocate Agency can help you decipher your medical bills and insurance benefits, call the hospital and insurance on your behalf when something is unclear, and coordinate your care after leaving the ER. We are here to help show you the way!