Freestanding ERs battle with insurance, cause high patient bills

Freestanding ERs battle with insurance, cause high patient bills
Free standing ER file photo
Free standing ER file photo

TYLER, TX (KLTV) - Free-standing emergency rooms are gaining in popularity.

"They like to go to the free-standing ERs because they're usually more appealing and they sometimes get treated faster," says Kerri Camp, a Health Management Professor at UT Tyler.

However, these centers don't always have the best relationship with insurance companies.

"As an emergency department licensed by the state, the law requires free standing ERs to be reimbursed by health insurance companies, [but] that unfortunately is not always the case," Says Brad T. Shields, the Executive Director or the Texas Association of Free Standing Emergency Centers.

In a press release posted to their website, the Texas Association of Health Plans says that freestanding ERs pose the biggest concerns for high prices because many of them chose to remain out of network, allowing them to charge up to 10 times more than similar urgent care centers.

"It's basically a blame game, the providers try to blame the insurance companies and the companies try to blame the providers but who really suffers is the patient," says Camp.

Camp argues that while most free standing ER fees are based on deductibles, the facilities aren't helping the issue because of their lack of transparency.

"What needs to happen is they need to be disclosing what their charges are going to be," says Camp.

She suggests that before heading out to a health facility, ask them to contact the respective insurance company in order to understand what the fees may be. Knowing the difference between emergent and non-emergent situations can also help save money.

"Urgent care centers are typically run by primary care physicians so they really function to help with flu, sinus infections, ear infections, minor injuries; not emergent situations," says Camp. "The ERs are for more severe problems...they can handle if someone's having a heart attack."

Camp says that if someone is still unsure where to seek treatment, their insurance provider can give them more information on the most cost-effective facility based on their plan and medical situation.

Copyright 2017 KLTV. All rights reserved.