Tag Archives: emergency room

Tips You Should Know to Avoid Hefty Medical Bills

Jeffrey Craig Hopper is a probate attorney and Little League coach in Austin, Texas, so he knows all about following the rules. Still, accidents happen. Last June on the Little League field, an errant baseball smashed into his face.

His wife, Jennifer, remembers rushing to the field.

“His eye was swollen shut enough that we weren’t sure if he could see,” she says.

Even in that moment of panic, Jennifer Hopper realized that there are rules when it comes to using health insurance that can hugely influence the size of the medical bill. Care providers who are “in network,” she knew, cost much less, so she made absolutely sure to drive Jeffrey to the emergency room of a hospital in Austin that is part of their insurance network.

That sounds straightforward, but, as the couple soon learned, it doesn’t always work out that way — some patients still get slapped with big bills, even when they try to play by the rules.

In the end, Jeffrey was OK — the ball broke some facial bones around his eye, but they healed and his vision was fine. Jennifer, however, was surprised by what happened next. After she’d already settled with the hospital, paying the copayments for the ER, the ER doctor sent the couple a separate bill for more than $700.

“It felt kind of random,” she says. “How do I know who’s going to charge me, and who’s not going to?”

Like many patients, Hopper assumed that if she went to a hospital that the insurance company had designated as being within her network, the doctors who work there would also, of course, be in the network.

But that’s not necessarily true. Emergency room doctors, radiologists and anesthesiologists often don’t work for the hospital. They work for themselves, often in large practice groups, and it’s up to them to sign their own deals with insurance companies.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Health Care Spending Down, For Now

The latest federal estimates of health care spending offer some good news: The growth rate for spending in 2013 will remain at a low level for the fifth straight year. But the bad news is, spending is expected to rise faster than growth in the economy over the next 10 years.

The big unanswered question is what role the Affordable Care Act has played and will play in prodding the health care system to adopt more efficient practices. The act uses competition among insurers and providers to hold costs down, offers free preventive services to head off more serious illnesses, and has started pilot projects to test new ways of paying doctors to manage a patient’s care, which will likely reduce needless hospitalizations and emergency room visits. While the recession and slow recovery may be the key factor holding down health care spending for now, some economists believe the act, by adjusting the behavior of health care providers, will continue to reduce growth in future spending.

The annual projections issued on Wednesday by experts at the Centers for Medicare and Medicaid Services estimated that national health expenditures would grow by 5.6 percent in 2014, up from 3.6 percent in 2013, and by an average of 6 percent a year from 2015 until 2023. For the entire 2013-23 period, national health expenditures would grow about 1.1 percentage points faster than gross domestic product. Ideally, health expenditures should grow no faster than the economy. But compared with past decades, these projected increases are an improvement; from 1990 to 2008, health spending rose at an annual rate of 7.2 percent, about 2 percentage points faster than G.D.P.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary