Dear Emergency Room Newbie: What you can expect from a trip to the ER

There are an estimated 141 million visits to the emergency rooms in America each year. And while none of us ever want to see the inside of an ER, it's not unlikely. A trip to the ER means you're in pain, and it's going to cost a few pennies. What happens in an emergency room visit? What does a trip to the emergency room cost? Should I go to an Urgent Care center instead of the ER? First, let's be clear about one thing: if you have a life-threatening condition - heart attack, severe burn, you ate a Tide pod - get yourself to the emergency room, STAT. Non-urgent conditions tend to fall under the flu/cough/animal bite/scrapes categories, and you may consider some less urgent (and less expensive) alternatives. Now that we have that out of the way, if you find yourself in need of a visit to the ER, here are a few tips on what to expect.

CHECK-IN

When you get to the ER, you'll check in and your condition will be assessed by a nurse, doctor, or EMT, who will put triage you (assess your condition, asking about the progression of your illness and taking your vital signs). If your condition is not life-threatening, you might be sent to the waiting room. ER wait times are unpredictable, but are known to be especially busy after 6pm, with Mondays being the busiest day. Generally, you should expect to be there for several hours (30 minutes in the waiting room, 90 for treatment). If your condition changes, speak up - let staff know immediately if your condition worsens. If possible, have someone to accompany you to the ER - ideally, someone who isn't afraid to be an advocate for your needs in that situation.

CARE

Emergency room doctors and nurses are dedicated to emergency care; meaning, their sole job is to take care of ER patients. Which is good for you, because they have a lot of experience with the kind of conditions that land people in the ER. You'll be seen by a doctor, who will determine your care needs. 

COST

The average cost of a trip to the ER is about $1,500 dollars, but can easily reach $3,000. Take a deep breath because, yes, that's a LOT of money. Your insurance may pick up the tab depending on the amount of your deductible and other factors, but if they determine that you could have received care at an Urgent CAre center instead of the ER, they may refuse coverage for that event. If you don't have insurance, you'll be responsible for the entire bill.The majority of your ER bill will be the facility fee (which does not include any care provided) and a multitude of other coded charges such as medications, dressing, stitches etc. Hospitals bill on how severe your condition is on a scale of 1-5, with 5 being the most severe. How each ER chooses to charge for service varies widely, and there's little transparency when it comes to how they determine charges. And if you arrived in the ER in an ambulance, that bill can run into the thousands of dollars

Why is the ER so expensive?

There are several reasons why a visit to the ER can be a real bummer to your bank account.

1. ERs are a monopoly, sometimes being a patient's only choice outside of standard business hours

2. Studies show that hospitals have gravitated towards using the most expensive codes in billing (more on that here)

3. A trip to the ER can be filled with "extras" such as MRIs, CAT scans and IV drips

4. Hospitals claim a need for higher rates in order to maintain overhead, i.e. hiring staff and keeping the lights on for 24/7 operation

Can I save money by going to Urgent Care instead of an ER?

Again, this all depends on your emergency situation (see above under life-threatening conditions). Many people visit an Urgent Care center because of the UC's walk-in availability, lower cost and flexible hours - often open early, late and weekends. Urgent Care centers are equipped to handle common illnesses such as the flu, colds, respiratory issues, scrapes, and fractured or broken bones. If your condition is non-threatening and you're unsure of whether to visit the ER or an Urgent Care, a quick call to a doctor via a telemedicine service can determine your needs (A Hippo Health doctor recently helped a patient reset a broken toe in a video call!). 

Also, coding mistakes are fairly common, so check your bill thoroughly. Hospitals aren't always transparent about how they bill, so you'll likely need to ask for a schedule of fees. 

Bottom line: Emergency rooms are absolutely your best bet when faced with a life-threatening condition. They are typically staffed with caring medical professionals whose primary interest is getting you better, fast. If your condition can wait, Urgent Care clinics or telemedecine options can help you save time and money. 

 

Kevin McGarvey