Access Granted?

January 3, 2009 8:32 AM

Had to go to the emergency room (I'm fine) and when I presented my insurance they said my "ER Access Fee" was 0$. So I paid nothing, but what does that cover exactly?

What does the ER Access Fee cover? I had x-rays done, a physician saw me and I was in the ER for about 6 hours. Surely that's not all covered, right?

I'm on a HSA and have a 5k deductible. Something tells me I'm going to be expecting a large bill in the mail pretty soon. I called the hospital and they were unable to give me any explanation of what the ER Access fee meant and of course it's Saturday and no one will pick up at Assurant.

I'm just trying to see if I need to panic now, or just wait until I get the bill in the mail.

posted by Hands of Manos to work & money (6 comments total)

You should expect a bill for hundreds of dollars for the exam and the X-rays. Maybe even two bills—one from the hospital and one from the physician.

If you were on a plan that used co-pays, you would have paid a co-pay at that point and then potentially not paid anything else later. You aren't, though.
posted by grouse at 8:42 AM on January 3

If it's in the hundreds then I won't sweat it as bad. If it's in the 1000's, they might as well put me back in the ER because I don't have that kinda money right now. I'll just wait and see how the insurance company negotiates with the hospital for the final bill.
posted by Hands of Manos at 9:08 AM on January 3

Don't panic either way. Even if it is in the thousands, hospitals do offer payment plans. It's a very common situation.

Last year I spent about 3 hours in the ER, got two IVs, and a head CT scan with contrast injected, and I think it was a few thousand. I would imagine x-rays cost a lot less than a CT scan.

Does your health insurance company have a website where you can register and look at an explanation of benefits online? Every insurance company I've been with has had this service.
posted by fructose at 9:37 AM on January 3

I have super-premium-awesome insurance and my ER co-pay is $75 if I'm not admitted, and $0 if I am. I can't tell you anything about your insurance, but there are plans that cover ER visits.

The testing though... that's a different matter entirely. Depends on the test how much it's going to cost. I had an MRI (which, luckily, I got insurance to pay for in the end) that was billed for $1,200.

Recently, out of pocket (between jobs and thus between coverage. Awesome.), I paid $800 in ER bills for seeing a Nurse Practitioner (MD would have been more expensive), getting some standard urine testing, and getting antibiotics for a UTI.

Call your insurance company. Do not panic. And remember, medical debt accrues no interest and can't be reported to credit bureaus. Throw the hospital whatever you can afford, whenever you can afford it and you'll be fine.
posted by grapefruitmoon at 9:48 AM on January 3

And remember, medical debt accrues no interest...
Often true, but not always.

...and can't be reported to credit bureaus.
Medical debt can be reported to credit bureaus like any other debt. But it has less effect on your credit score than voluntary borrowing does.

The ER Access Fee is a provision of your health plan, not an itemized charge made by the hospital. It's like an "office visit co-pay". A typical plan's ER Access Fee might be $100; with 80% coverage of the rest of the bill. Since you have a $5K deductible, you'll be paying the entire bill. It will be a few days before the hospital can tell you what the amount of the bill will be. Assurant may have a contract with the hospital specifying the approved payment rates for your services, but it may be several weeks before Assurant will receive and process the claim and be able to tell you the amount you owe.
posted by Snerd at 10:27 AM on January 3

Snerd,

Thanks. What I'm hoping is that Assurant will negotiate the bill for them. That's what they've done in the past. I hope, anyway.
posted by Hands of Manos at 10:53 AM on January 3