Surprise Emergency Room Bills Could Catch EmCare Patients Off Guard

Many patients, when entering an emergency room, are already under a certain amount of physical and emotional stress. They expect to receive treatment, and if they have insurance, they expect their insurance will cover most of the costs.

What are Surprise Emergency Room Bills?

When a patient signs up for medical insurance, he or she expects to pay a portion of the whole amount of what a medical procedure, doctor’s visit or surgery actually costs. Doctors, hospitals and other medical organizations contract with insurance companies to provide lower cost services for patients who are members of the insurance organization.

A patient pays a “co-pay,” or an agreed-upon amount to the doctor’s office or hospital for the services rendered. The insurance company pays the difference between the actual cost and the co-pay.

When a doctor or hospital has an agreement with a patient’s insurance company, this is considered “in-network.” It is always better for a patient to visit an in-network doctor or hospital because his or her services will most likely be at least partially covered by insurance.

If a patient sees a doctor or elects to have a surgery or procedure performed at a hospital that does not have an agreement with the patient’s insurance company, this is considered to be “out-of-network.”

If a patient is aware that a procedure or office visit is out-of-network, then paying full price or extra for a procedure is expected. However, sometimes a patient is unaware that a doctor or hospital is out-of-network. In these cases, patients may be hit with steep surprise medical bills that can be multiple times the amount that they believed they would pay.

This can be quite common for emergency room visits. There have been many instances where an emergency room is not under the same insurance contracts as the operating hospital. Additionally, doctors in emergency rooms may not be under the same insurance contracts as the hospitals in which they work.

In these cases, patients can be hit with very high surprise emergency room bills.

Filing an EmCare Lawsuit

If you have gotten surprise emergency room bills, they may have come from providers contracted through EmCare. If you are not sure if the hospital at which you received treatment qualifies under EmCare, please check out the list of EmCare hospitals. You may qualify to join a free EmCare class action lawsuit investigation.