Seriously?!?!

RW23RN, BSN, RN · Feb 23, 2013

I'm a little confused as to how a nurse would know what a patients co-pay is to begin with since it is against the law to ask someone in the ER if they have insurance and how they intend to pay. So how do you know what the co-pay is for medicaid or medicare?

Oh, also you can thank the computerized EHR for that. On my initial patient screen all your info pops up-regligion, allergies, insurance-and sometimes a nice scanned photo of your insurance card. Its not that everyone on medicaid gets a free ride, its that a lot of people use the ER as their PCP because they know they pay nothing upfront.

Kudos to your for paying your copays though! Its nice to hear there are responsible people out there

thenursemandy · Feb 23, 2013

Nasty!!!!

redhead_NURSE98!, ADN, BSN · Feb 23, 2013

I have medicaid and I pay a co-pay. I'm a little confused as to how a nurse would know what a patients co-pay is to begin with since it is against the law to ask someone in the ER if they have insurance and how they intend to pay. So how do you know what the co-pay is for medicaid or medicare? I'm assuming it's that old mindset by a lot of people who work in the medical field that people who have medicare or medicaid don't pay a cent.
I also have co-pays for prescriptions. The notion that it's "free healthcare" is just a myth.

Well thank you for assuming that my only job history is in nursing, you'd be wrong.

Where in the world do you get that it's "against the law" to ask about insurance in the ER? I guess every registration employee in every hospital I've worked for should be sued or arrested then.

TennCare's copay for prescriptions: $3.00. THREE DOLLARS and they still won't get their necessary prescriptions filled. They'd rather come in for acute renal failure, urosepsis, and limbs that are near falling off because they wouldn't go get some Vibra Tabs.

"TennCare Medicaid adults have pharmacy co-pays only . You don't pay co-pays for other TennCare services."

http://www.tn.gov/tenncare/mem-copayments.shtml

And from my home state, an article laying down the stark reality that OMG WV Medicaid recipients MIGHT have to start paying a copay!

http://www.dailymail.com/News/201301100224

SionainnRN · Feb 23, 2013

Well thank you for assuming that my only job history is in nursing, you'd be wrong.
Where in the world do you get that it's "against the law" to ask about insurance in the ER? I guess every registration employee in every hospital I've worked for should be sued or arrested then.

THANK YOU!! How and why would it be illegal to ask someone in the ER if they have insurance or how they're gonna pay for it?? My ED is now starting a check out desk where the registration person will go over their discharge info plus get them to pay what they can. Hopefully this will start cutting down the non-emergent visits we get. There are so many visits that can wait till an urgent care is open. People have no idea what Emergency stands for.

Katieerin · Feb 23, 2013

It's hard to get people into rehab. Most don't have insurance and are not at a point in their life when they want to quit anyways

Agreed! Not only that in my hometown the patient had to agree to the rehab or have a court order or else the facility could not admit the addict even with family trying to "help".

JZ_RN · Feb 23, 2013

I have medicaid and I pay a co-pay. I'm a little confused as to how a nurse would know what a patients co-pay is to begin with since it is against the law to ask someone in the ER if they have insurance and how they intend to pay. So how do you know what the co-pay is for medicaid or medicare? I'm assuming it's that old mindset by a lot of people who work in the medical field that people who have medicare or medicaid don't pay a cent.
I also have co-pays for prescriptions. The notion that it's "free healthcare" is just a myth.

Um, I went to the ER one time in my life because I had a bleeding wound (acute from a cut with a knife, accidental) and it bled for 2 hours without stopping, nothing I tried help. The nurse asked if I had insurance and charged my credit card for co-pay of $100 dollars in the triage bay, so no, it's not like they don't ask if you have insurance and I'm fairly sure it's not illegal. And I work primary care and there is no co-pay for caresource/medicaid patients there. The drugs are fairly inexpensive too, though the formulary is limited.

Sassy5d · Feb 23, 2013

Also, when someone asks for an rx of an OTC medication like Tylenol 'so my insurance will pay for it' that's a pretty good indicator of how they are insured.

Sorry to say, but your 'insurance' or lack there of DOES have a place in your plan of care. As a nurse, does it matter? Nope. But your 'insurance' may dictate that you have to be transferred to a different hospital for an admit

I've never seen it, but I've heard of people being denied treatment/surgery due to lack of insurance because it's not 'life threatening'. Heard stories of people with broken bones not getting surgery because of lack of funds.

Why can anyone think ER's are frequented so much? Because it's FREE (to them) along with the free ambulance ride and bus pass home. Urgent Cares charge fees up front and CAN turn you away and so can doctors offices. People use ER's as minute clinics because it's more cost effective FOR THEM while people with private insurance come in half dead because they can't stomach the 50-75-100-200 copayments.

brandy1017, ASN, RN · Feb 23, 2013

With our crappy health insurance I literally cannot afford to go to the ER! Was having a reaction to BP med and refused to go can't afford to spend close to a thousand dollars with our crappy insurance. Even if you go to the "urgent care" they feel free to bill as ER visit to maximize their profit at our expense! Luckily dr gave me some steroids and took benadryl to deal with the allergic reaction. It's sickening that we work for hospitals and have to deal with such crappy benefits! I have coworkers who've had to file for bankruptcy due to the thousands of dollars in medical bills our crappy insurance plan leaves us with!

Next time I have a medical problem I'll go to Walgreens clinic and pay the $70 myself and screw the hospital's overpriced clinic and er!

Sassy5d · Feb 23, 2013

Or the '6 hour wait in the waiting room' because 300 people are there for a rash x's 1 hour or 'my kitty got da stank'

Ruby Vee, BSN · Feb 23, 2013

Lol brick wall sometimes. Large volume of non-ER posters. What draws people in to this specific forum?

It's funnier than the ICU forums.

Ruby Vee, BSN · Feb 23, 2013

When people come in with gnarly, nasty feet, it's called Walmart feet. I didn't make it up, I actually heard it first from a doctor. Maybe your Walmarts are nicer than ours, but it's common to see gnarly, nasty feet in Walmart (along with a host of other things that make me a Target shopper).

I don't know about where you are, but the Target crowd here is just as nasty as the Walmart crowd.

**NICU Guy, BSN, RN** · Feb 23, 2013

ER Nurses are not without they're moments also. I was an advanced EMT on a Paramedic ambulance.

ME: ****** Hospital, Medic 1 -enroute 10 minutes out, CPR in progress

NURSE: copy Medic 1. What are the vitals?

ME: Alert and oriented times zero, B/P: zero over zero, pulse: 60 by compression, respiratory rate: 15 by AMBU bag. Anything else?

DIFFERENT NURSE: No, we will be expecting you in Trauma 1.

I get to the ER and say "Seriously? Vitals with CPR in progress?