Can’t Afford Your ER Bill? What to do.

What to Do When You Can’t Afford Your ER Bill

Regardless of how organized you are with your money, nobody is ever fully financially prepared to deal with a medical emergency.

In recent years, most Americans have developed a real fear of having to visit a hospital or emergency room. According to a study done by Harvard University, medical expenses were responsible for 62% of total bankruptcies in the US with 72% of those who filed for bankruptcy due to medical costs having some form of insurance. If you are insured, you should be covered, right? The fact is insurance companies will do everything possible to avoid paying claims.

With the growing trend of insurance companies looking for unlawful ways to deny emergency room visit claims, what can you do to avoid financial distress?

1. Don’t Panic!

We know having to deal with unexpected medical bills is a source of dread and anxiety, but the worst thing you can do once you receive a bill from the emergency room is to panic.

Allowing anxiety to take over can cause more problems for you down the road. Keeping a clear, calm attitude will let you review your bill and figure out what your next step should be.

2. Review the Bill for Errors

Calmly check the bill to make sure you are being billed for the treatment you received; there have been cases where a patient was double billed for the same service by mistake, or even being charged for a procedure they did not receive.

• If your bill does not include a detailed description of the charges, call the provider and ask them to send it to you.
• It’s important to know that healthcare providers use codes known as Current Procedural Terminology (CPT) to report medical, surgical, and diagnostic procedures and services, you can search for them on the internet to decode their meaning.
• Make a list of any items you have questions about.
• Call the billing department at Altus Emergency Centers to make an appointment to review your bill as soon as possible. It will be corrected, and a new statement will be sent to you.

3. Contact Your Insurance Company

If you have health insurance and feel you should not have to pay the amount owed, you need to contact your insurance agent as quickly as possible to ask why they are not honoring the terms of your insurance plan.

• If your insurance company says the CPT code on the insurance claim is not covered by your plan, ask them which codes are covered by the program. This is important because in some cases our billing department might be able to change the code for a similar one that is covered by your insurance plan.
• When your claim was denied because your insurer did not consider your procedure to be medically necessary, our doctors would be happy to write a letter explaining why the course of treatment was required.
• If the insurance company is refusing to pay for your emergency room visit because the ER was not in network, let them know you are aware of your rights as a patient, and that the law requires insurance companies to pay for emergency medical treatment regardless of whether the facility is in-network or not.

4. If All Else Fails, File an Appeal

There will be times when your insurance company will try to use fear tactics to get you to back down and pay out of pocket for services that should clearly be covered in your plan.

If you have tried to reason with them, and it has not worked, contact the Patient Advocate team at Altus Emergency Centers and bring them up to speed with everything you have done up to that point. They will try to speak to your insurance provider, and if they are unable to resolve the issue, they will gladly file an appeal on your behalf.

If your formal appeal is denied, you can refile another, and if the insurance company declines that one too, then you can request your claim to be reviewed by an independent third party who will give a final resolution.

5. Negotiate

If all your appeals are denied, or you are uninsured or are unable to pay the out-of-pocket amount, there are options available for you.

At Altus Emergency Centers we offer financial assistance for patients who cannot afford to pay their bills at once.

The first thing we will recommend is that you request a payment plan rather than use your credit card to pay for the amount due. Our Patient Advocate personnel can design a payment plan that fits your budget.

While it’s always a good idea to save for a rainy day, a medical emergency can happen at any time and to anyone. At Altus Emergency Centers we firmly believe that no patient should ever hesitate or fear to come in for treatment for fear of receiving a bill they cannot afford. For this reason, our Patient Advocate staff will work hard to ensure you receive the full benefits of your health insurance plan.

Contact our Patient Advocate department if you feel your insurance company is not honoring the terms of your healthcare plan, we can help you understand your benefits and your rights as a patient. We can also assist with the lengthy and often confusing health insurance appeal process.

Remember Altus Emergency Centers and the law are on your side!