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by rotor
Sun Oct 07, 2018 3:26 pm
Forum: Off-Topic
Topic: Stand Alone ER's / Rip Offs or ...?
Replies: 35
Views: 10059

Re: Stand Alone ER's / Rip Offs or ...?

Although many advertise that all insurance is accepted you would be smart to precheck with your insurance company to make sure that they will pay the bill if the freestanding center is used. Blue Cross on my wife's plan has us paying the bill for almost all ER hospital visits unless it is a true emergency (prove that). I don't think they cover freestanding units. Next, will the freestanding unit accept Medicare? Probably not. Medicare Advantage is not Medicare so if you are on one of these plans really check to see if you can use a freestanding unit. I would bet NOT.
Do they make you sign a balance billing form? The bill is $5,000, insurance pays $300 and you owe $4,700. That's balance billing.

Are the doctors good? In my city, the same doctors working the hospital ER work the freestanding unit (which they own) so they are good. Finally, and I don't know if this is the case, but there may be multiple type of bills and this includes any ER, free standing or not. There is a lab bill, an X-ray bill, a facility fee, a pharmacy fee, a supply fee, multiple physician fees (ER doc, radiologist, pathologist, who knows what else) and you need to know if their fees are covered by the insurance. Very complicated. For example, all of the neurosurgeons in my town are not in network for my wife's Blue Cross. We pay cash when we see one.

Don't assume the "all insurance accepted" means that you are home free.

Edit: I should have said neurologists instead of neurosurgeons. We pay cash to see a neurologist. Also, Blue Cross web site says the neurologists WILL accept her insurance but when you call they say NO and they can not get Blue Cross to remove them from the web site. So, don't just trust that the web site is correct about who is in network.

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