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Medical Matters Hit Where It Hurts

Amanda Bar

About three months ago I had a sudden but non-serious medical matter that sent me over to my local ER to resolve.  I haven't had a regular physician for quite some time, and since I was in a bit of pain I figured that the emergency room was sufficient for my needs - as well as for my insurance company.

I signed the papers, was seen by the doctor, referred to a regular physician (who I plan on seeing from now on) and everything was well & good...until the bills started rolling in.  At first I thought it must have been a mistake of some sorts with my insurance company - or perhaps I had put down the wrong numbers on some form somewhere?  Why was I getting billed when I have regularly been paying for the same insurance company for four years (this was actually my first claim!)?

After I called my insurance company I discovered that I am indeed covered for ER procedures/consultations, but only if the doctor lists it as an actual emergency.  My little tête-à-tête with the doctor was listed by the physician as a non-emergency (and rightly so, to be honest), and thus I have to fork over payments of $492 and $316, all for a five minute face-time session with a doctor who did nothing but refer me to another doctor.

Again, I can chalk this little disaster up to the fact that I don't do my research.  If I had, I would have known way back when I signed up for my insurance that going to the ER for non-emergencies is a bad idea...but I was in moderate amounts of pain, it was late in the evening, and I didn't have a regular physician to fall back on should I have waited.  Unfortunately, I have to pay out of the butt to learn this particular lesson regarding my insurance policy.

Posted by Amanda Conwell at 03:54 AM on July 26, 2010 in Savings | Permalink | Facebook | Digg | del.icio.us | AIM


Rochelle Broder-Singer

Also, check out your insurance company's policy on Urgent Care, and find out where the nearest covered urgent care clinics are located. It's a great alternative to the ER when you do need to be seen, but don't need the ER. Many can even handle minor sprains and breaks, and other emergencies that aren't "call the ambulance" emergencies, and most have very late hours.


Rochelle -

Thanks for the advice, and I will definitely keep the address to an Urgent Care clinic handy for my next "non"-emergency!


I had to somewhat chuckle at your expensive experience. For someone like you who pays for insurance and who pays your bills, it was a lesson indeed.

Howveer, for those who routinely use the EMR rooms for medical services (sucha as at JMH); but who do not have insurance and do not bother to pay their bills, they do not worry about whatever bills the hospital issues ...under the existing conditions, the hospitals cannot turn these "dead beats" away in spite of their repeated failure to have paid for any previous services ... and that costs all of us tax payers, doesn't it?

Julia Wakefield

Ditto Rochelle... Urgent care centers cost a fraction of what emergency room visits cost, and they can perform most of the same non-emergency services. For instance, a couple years ago I had a possibly broken nose and needed stitches. Went to the urgent care center, had an exam, x rays, stitches, everything I needed for a copay of (if I recall correctly) $40-$50. Your insurance company should be able to provide you a list of local covered urgent care centers. Better luck next time!

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