ER's Turn Non-Emergencies Away? - page 2
The below article appeared on the website of a local news station in Rock Hill SC. Some people in the community have varied opinions about this. For those of us "in the business", what do you... Read More
May 18, '09Occupation: RN, ER and Home Health Specialty: 2 year(s) of experience in ER and Home Health ; From: US ; Joined: Mar '09; Posts: 202; Likes: 156Quote from NurseCardAren't emergency room visits more expensive than visits to a primary care physician????
Sure but can you always get into see a PCP. More often than not if you call they cant get you in for at least a few days. That leaves urgent care if you have insurance or money. BTW most urgent cares do not accept medicaid or medicaire. They want good insurance and cash up front. Free care clinics are scarce enough. They see people usually on a first come first serve basis, some have appointments. But when it is time for them to close at the end of the day, they close. And say try again or go to the ER.
Medical care outside of the ER is even more so now than ever before for the haves, not those without. I know several doctors outside of work. They do not accept any charity, medicaid, or medicaire work.
So what is left, go to the ER.
May 18, '09Occupation: floor nurse Specialty: Med Surg, Home Health, Dialysis, Tele ; From: TX ; Joined: Nov '08; Posts: 118; Likes: 81I didn't have insurance as well before I became an RN. I just prayed I didn't get sick. I surely didn't go to the ER( I didn't have any money either), now there are various clinics, some that are staffed with nurse practitioners, that are about $60-70 for an offc visit where I live. So it is attainable now for people. A lot of times the ER is used not only for primary care but also a free ride. :zzzzz
May 18, '09Joined: Dec '03; Posts: 3,045; Likes: 5,015Okay, yeah I didn't think about the fact that doctors' offices want their money upfront.
May 18, '09Occupation: Nurse Intern From: US ; Joined: Feb '07; Posts: 10; Likes: 12Thank you Angie O' Plasty for understanding.
May 18, '09Occupation: RN, ER and Home Health Specialty: 2 year(s) of experience in ER and Home Health ; From: US ; Joined: Mar '09; Posts: 202; Likes: 156Quote from oramarIf it is not an emergency and I "DO" have insurance will I be treated any differently?
Actually, yes. If you have insurance you can keep coming to an ER, and be seen for whatever. If you are a drug seeker and have insurance then you wont be turned away. But if you do not have insurance then a MSE will give give the option of paying up front in cash, not check. Or you have the option of going elsewhere.
The Haves vs the Have nots
May 18, '09Joined: Apr '01; Posts: 1,243; Likes: 832There is more to it than the haves and the have nots. The medical screening exam has been around for a long time and if you search there are other threads here on the subject. Most hospitals who utilize the MSE usually have set protocols. The old and young are excluded, preg issues are excluded, out of range vital signs are excluded. In one facility I worked at if a female showed up for STD check we had to see her, but if a male showed up, he was refered to the county health dept.
In some cases it's not the policy that is the problem, in some cases it's the provider that is teh problem. Some providers are just jerks.
May 18, '09Joined: Oct '08; Posts: 239; Likes: 271Quote from oramarIf it's not an emergency your insurance may not pay. My husband recently went to the ER for dizziness and we got a letter from our insurance company saying it was not deemed an emergency and they would not cover the bill.If it is not an emergency and I "DO" have insurance will I be treated any differently?
This ticked me off because I am an ER nurse and I see all these freeloaders that come in for minor complaints and never pay a penny. My husband who was too dizzy to walk and has insurance couldn't get covered. I've never been so mad. I tried to appeal it but didn't get anywhere.
May 18, '09Joined: Feb '09; Posts: 7,636; Likes: 26,310Nursecard;
Yes, they are. But PCP's don't necessarily have to see you. An ER would have a hard time turning a patient away.
May 18, '09Specialty: 13 year(s) of experience in Acute Care/ LTC ; From: US ; Joined: Feb '09; Posts: 92; Likes: 100my mom used to say, "one bad apple spoils the whole bunch". basically all of the people who abuse the system whether it be by getting "free" service, or wasting valuable ER time, those are the people who ruined it for those who really need to go to the ER.. Imagine being turned away and it turns out to be more serious because the person had waited until the next morning to go to a doctor if at all.
i don't think there will ever be anyone happy with the ER policy no matter what. it is kind of sad that it had to get like this
the whole health care system seems a mess to me...
just a thought :-(
May 18, '09Occupation: Educator Specialty: 28 year(s) of experience in Critical Care, Nsg QA ; From: US ; Joined: Jul '08; Posts: 237; Likes: 257Quote from oramarIf it's not an emergency, you shouldn't be at the ED, regardless of insurance.If it is not an emergency and I "DO" have insurance will I be treated any differently?
May 18, '09Occupation: RN Specialty: Cardiac-Telemetry ; From: US ; Joined: Nov '06; Posts: 1,062; Likes: 568I've been on both sides of the fence on this issue as well. Actually I've been on the unisured part for quite a while, though I do have a PCP. She only charges $60 or less for a visit, but the trick is having that $60 sometimes. I recently had to go to the ER because I was wheezing for over a week and was starting to get worse. Waited in the ER for a complete shift, but was seen. Turns out I was in the middle of an asthma exacerbation that could have gotten much, much worse...but I didn't have the money to see my PCP. I qualified for the medassist program as far as the actual ER bill goes, but I still have bills for the Dr. and Radiologist separately. I hated having to go to the ER and our Urgent Care does have a payment plan, but you still have the money up front. We do have a free clinic for the tri-county area, but they are only open twice a week and if you end up far back in the line you won't get seen. The last time I went I stood outside for over 3 hrs to get a good place in line only to be told that I couldn't be seen because of my previous year's income. Now, I do think ER's should not be used for non-emergencies....but honestly where do you go when there are no other options. I personally hate going to the ER because I feel they seem me as a freeloader or worse just because I don't have insurance. I also know from personal experience if you don't have insurance PAC's get diagnosed as an anxiety attack, same with hypoglycemia since it wasn't "hypo" by the time I got seen. That last one, my PCP at the time told me to go straight to the ER after I told him what my BS read at. I guess I shouldn't have self treated it before going to the ER huh?
It's a no win situation for all involved IMHO and my
May 19, '09Occupation: Full Time Emergency/Trauma ; Part Time Educational Consultant Specialty: 18 year(s) of experience in ER, Trauma, ICU/CCU/NICU, EMS, Transport ; From: US ; Joined: Aug '06; Posts: 572; Likes: 400If it is not an emergency and I "DO" have insurance will I be treated any differently?
They would probably ask you for your "ER" co-pay that your plan has as well as any deductibles.
Remember, even if the self-payor pt doesn't have an emergency, BUT they pay the $200-$250 up front, then they can get treated.
May 19, '09Occupation: Full Time Emergency/Trauma ; Part Time Educational Consultant Specialty: 18 year(s) of experience in ER, Trauma, ICU/CCU/NICU, EMS, Transport ; From: US ; Joined: Aug '06; Posts: 572; Likes: 400Quote from LHH1996i don't think there will ever be anyone happy with the ER policy no matter what. it is kind of sad that it had to get like this
the whole health care system seems a mess to me...
just a thought :-(
I don't think that it "had to get like this"..."This" was the way it was intended to be.
At least that's what the Federal EMTALA standard guaranteed - that everyone would get a "medical screening exam" (not necessariaily treatment) to see if they had an "emergency medical condition".
If no "emergency Medical condition" exists, the obligation for further treatment ceases.
However, we, as a system have allowed the "treatment" to go on despite no "emergency medical condition" existing.
I'm not against treating non-emergencies, I'm just stating the original intent of EMTALA and the purpose of the MSE.