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The CDC reports that 1 in 5 American adults will visit the emergency room each year. Spend five minutes doing research now to save yourself thousands of dollars if you ever have a health emergency.
Several years ago, I went on a business trip to a developing country. I came back with some mysterious affliction that caused me to be unable to swallow without it feeling like knives were in my throat, and my husband (then-boyfriend) woke up in the middle of the night to me gurgling that I was in intense pain and that I was having trouble breathing. He googled for the nearest emergency room, hailed us a cab, and got me into the hospital pronto.
That hospital turned out to be Bellevue Hospital. They got me through that night, diagnosed me with pneumonia (my left lung was filled with liquid) and gave me something for the never-identified razor knife pain in my throat. I am so grateful for those medical interventions when I needed them most. I was less than thrilled when I got my bill 45 days later. Turns out Bellevue was out of network with my insurance. Let’s just say the bill had a few more zeroes than I had expected.
I don’t blame my then-boyfriend. I would have done exactly what he did in an emergency. Being me, I did have a moment through the pain when I was laying in one of the beds where I wondered whether the hospital was in-network, and I went so far as to ask the nurse. She had no idea, and to be honest, it was too late anyway. The person I had to blame was myself. I should have researched ahead of time so when an emergency struck we would know exactly where to go.
Fortunately our plan’s out of network benefits weren’t awful; our lack of research only cost me about $1,300 more than I would have paid with a better provider. I now have crappy high deductible health insurance, and the same mistake today would easily cost me $4,000-$5,000.
The 5 Minute Solution
The challenge with health emergencies is that we face them so infrequently, which makes most of us inexperienced and clueless with how to best approach them. By the time a family member falls ill, it’s too late to fire up the computer to borrow others’ experience and do it right. But you’re here preemptively and that means you can avoid this costly mistake with a simple solution.
You can save thousands of dollars by spending 5 minutes right now to look up the closest in-network emergency room and urgent care center to your home. The major carriers make it easy, offering in-network directories directly on their websites. I recommend going through your insurance provider rather than calling up an individual hospital as the hospital’s lists may be outdated.
I personally like to have both an urgent care and an emergency room option. Urgent care options are generally less costly, and you may find yourself in the position of wanting immediate care – particularly after typical business hours – but not necessarily emergency care.
Once you have that information, you can tape it on the refrigerator or put it in the glove department of your car and then forget about it.
While we all hope never to have to use this information, the truth is that data suggests you will. The CDC reports that 1 in 5 US adults will visit the emergency room each year. In a ten year time period, you are extremely likely to have to avail yourself of emergency services, and you can save yourself thousands of dollars with a few minutes of work right now.
And make sure to update your research with each move. The average person moves 11.4 times in his/her lifetime. It would be an absolutely travesty to let your lack of research drain you as many as 11 times in your life.
Other Advantages – Better Care
There are other, perhaps even more important advantages to doing your research ahead of time. You will be able to do a quick scout of how the patients and the medical community view the facility in question. Back to Bellevue. Bellevue was the closest hospital to our apartment at the time. And it was fine. But it was also a teaching hospital and one of the major city hospitals earmarked for police to drop off drunks.
This meant that my night in the emergency room was an absolute circus. I remember a doctor (resident) coming to insert an IV. She made four attempts to insert the IV into my vein, all of them very painful. After the fourth attempt, there was a pause, and then I heard, “Let me get something to clean up the blood.” Do you know when you want to hear those words from the person inserting your routine IV? Exactly never. I spent the rest of the night with a sheet on that half of the pallet so that I wouldn’t turn and see blood every time I rolled over. Lovely.
That was just the tip of the iceberg. We had several interesting drunk characters. One extremely well-dressed yuppie guy started wailing for his mother, immediately shouted afterward that he was fine, then tried to get off his bed and fell on the floor five feet away from me. Another gentleman was fighting with the doctors, arguing he truly was sick. It sounded like he just wanted a place to sleep for the night as I heard one nurse telling the other they’d seen him several times this month. They ended up discharging him after an hour.
There was more. The wait for the x-ray machines was long. It was hard to get the nurses’ attention. I waited over 20 minutes for a cup of ice chips. All in all, it was an adequate experience but not a great experience. If we had done our research ahead of time, we would have realized that 10 blocks away was a world-class hospital, NYU Langone, which was in-network, had better facilities, and fantastic care. I learned from my Bellevue experience and we ended up at Langone when my husband had appendicitis. His care was top notch.
Advanced research can lead not just to huge savings, but also to better care for you and your loved ones in their time of need.
Bonus Money Saver Tip
Sometimes you will find that while the facility you chose is in-network for you, not every provider who works on your case will be. I have gotten one or two surprise bills where a specialist turns out not to be in-network, and I have numerous friends who have come out of the woodwork to share similar stories. One friend of mine had to fight a $30,000 bill because one of the doctors who delivered his son turned out not to be in-network.
A friend of mine who is particularly savvy with issues like these mentioned to me that she has often been able to get her insurance provider to re-bill out of network charges as in-network. She makes sure to tell the facility that she wants only in-network providers and if she gets a bill for an out of network provider, she calls her insurance directly (not the provider) and explains that she was explicit about only wanting in-network care. Her carrier has told her that medical centers are not obligated to accommodate your request for only in-network providers, but somehow they have been able to re-process this for her on multiple occasions. Your mileage may vary with this tactic, but consider tucking it in your back pocket in case it ever comes up.
When an emergency strikes, our thinking is often at its cloudiest. You can help yourself and your loved ones by using your clear mind of today to ensure the best experience for the future, both financially and medically. Wishing you all good health, fat pocketbooks, and a rock solid emergency plan.
Have you ever had a nasty health bill surprise? Any lessons you’d share on what to do or how to navigate them?