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WisconsinChristianNews.com
Volume 26, Issue 7
Saving Money In the Emergency Room
By Dr. David Lange, Genesis Primary Care Year-End 2025 Is it even possible to save money when you are in the Emergency Room? Emergency Rooms operate under the notion that you would want everything done to save your life, hang the cost. This is
of various emergencies. These standards have per- formance based measures built into them. There is little forgiveness from management for not meeting these performance goals. These protocols are on au- topilot once a patient presents with certain com- plaints, even if that really isn’t the problem. Coming in with the complaint of chest pain will automatically
see only one way to save money, don’t have some- thing done. If you are able to insist that you are seen by the physician first, before any protocol is enacted or automatic test or procedures are started, the physician may be able to get you off that protocol pathway and have the appropriate tests completed for the complaint that you are in the Emergency
is not used. If it got opened, then you get charged for it. If you can clearly document what you had done you may be able to get that charge reversed. One example may be for a suture set that was opened when the patient has a laceration, but when the physician gets there, the laceration is not so bad and some other closure is applied. You should not be paying for something that was not used. There can be double charges. The doctors and nurses are re- sponsible for documenting what was done during your visit, but often there are coding specialists that go back over everything to make sure that every penny is accounted for. While those coding special- ists are skilled at their jobs, that doesn’t mean that they are mistake free. I know it will be impossible for the patient and their advocate to know of everything that needs to be used for their care, but taking the time to review the bill in detail may help lower the bill. Insurance policies have different coverages for emer- gency care. It is important to understand what the limits of your policy are. For the cash patient, always ask about a cash discount. Insurance companies have negotiated rates and never pay full price. Many times the facility will offer a similar or even slightly better discount for those who ask for it, but it may require paying the bill in full to get the discount. The fees that hospitals charge are supposed to cover the cost of doing business, but remember, the visit is the only way to bring money into the hospital and there are many people that a hospital employs who are not in patient care and the charges need to cover their pay and bene- fits. Emergencies happen. This is real life. We do things that can end badly through no fault of our own. Doing what we can to mitigate risk will reduce the chances we end up in the Emergency Room, but we are not the only ones on the road or job site. Doing those things that keep us healthy is also important. Eating fresh foods, exercising and getting appropriate rest are all important for us to maintain a healthy body and reduce the risk of serious health conditions. The hospital staff providing care for us under po- tentially very difficult circumstances need to be ap- plauded for the work that they do. Some of us wouldn’t survive without them. But when all is said and done, we do not need to be foolish with our money. GenesisPrimaryCare.com Please see the display ad on Page 20 of this issue of Wisconsin Christian News).
not a bad assumption, but is that an excuse to run every test under the sun? Bottom line is: It is possi- ble to save yourself some expense, but maybe less than you are hoping for. Staying out of the Emergency Room is the only way to truly save money. Having a good relationship with a direct primary care practice where you can get not just preventive care, but also timely and appro- priate care for urgent issues is critical to staying out of the Emergency Room. Early treatment for many conditions will turn the corner for the illness from se- rious to manageable. But things happen and it isn’t always possible to avoid the Emergency Room. If you find yourself in need of emergency services, then you should be in the Emergency Room. If you need to go to the Emergency Room, and it is safe to do so, taking yourself in by private car is free. Going by ambulance is very expensive. These heroes are called in when something bad has hap- pened to us. There are different levels of response. When the call goes out, there is no way to ask them to send the least expensive option. They will send what is thought to be required for the situation as de- scribed to the dispatcher. It just is what it is. Once you are at the Emergency Room, the care that you need may not be available and a transfer to a differ- ent facility may be required. A helicopter transport may sound like the fastest, most comfortable way to get to that next level of care, but it is very expensive. An ambulance ride will take longer, but it may save money. There are different levels of care that can be provided in the ambulance and again, that changes the charges. I guess this is more of an explanation than an area that you have much control over. You could still ask if transport by private car is an option, but if it is, the question that insurance may ask is “Was any of this really necessary?” Claim denied. As seems to be the case with all things Corporate Medicine these days, Emergency Room personnel are measured by their performance. Various medical societies have developed standards, that are based on medical studies, to try and optimize the outcomes
trigger labs, EKG, chest X-ray, aspirin, an IV and possibly nitroglycerine. All of this happens before you are even seen by a physician. Time in the Emergency Room is expensive. There are reasons to be in the ER for monitoring and wait- ing on tests to be completed, but your presence there means you are being monitored and that is a cost in personnel and equipment. Lab tests in an emergency are critical to under- standing what is happening to a patient. But they can be remarkably expensive. How many tests are needed? How often? Imaging studies can be fairly reasonable to wildly expensive. The same questions apply: How many are needed? How often is the test needed? IV access can be critical in an emergency situation. If someone is reasonably stable, it is much easier to place an IV instead of trying to place one when they are no longer stable. It seems like most people who end up in the Emergency Room end up with IVs even if they are there for a condition that has little chance of destabilizing.
Room for. This leads to the other part of saving money, negotiating what is really needed to ensure your safety and to get you a diagnosis and treatment plan without over testing. Having an advocate may be critical — especially if the patient is not in a good position to be speaking up for themselves. An advo- cate can ask questions about the necessity of tests. Any medications or supplies that are being used will be charged to you. There may be an opportunity to save a bit here if you know to ask at the time of serv- ice. Most braces and supplies are available without a prescription and can be purchased at a local re- tailer or online for a fraction of what the hospital will charge. Medications that are used during your visit are less likely negotiable but anything that is going to be sent home with you may be something that you have control over. Certainly, if you are not intending to take a medication, like a pain pill, don’t take the medication as you will be charged for it. A prescrip- tion that will be sent to a pharmacy doesn’t cost any- thing until it is picked up. There are a couple of things that one needs to be mindful of after the Emergency Room visit. A lot goes on while providing care. There are a lot of supplies that may be used. Scrutinize the bill carefully to be sure that you are paying only for the things that were actually used or done. It is common for staff to open up something thinking it may be needed and then it
Once you are in the Emergency Room, is there anything that you can do to save money? I guess I
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