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Nonsense. My last 3 employers , all self insured using insurers like BCBS to administer, provided full details: List price of procedure, insurer discount, employer's portion, employee's portion, etc.
Actually you proved my point.. The reason being the part in bold..
If one has no skin in the game, they dont give a crap...
We're discussing individuals.. You cited businesses, who again, have skin in the game since they are paying a percentage of the cost.
No because I was trying to gut through it. It wasn't until day 2 at 6:00 PM (when most urgent cares by me are closed) I decided it was a good idea. Plus the urgent care would have at best regards me to the hospital anyway because the stomach pain was not a typical stomach ache and instead a gallbladder attack from gallstones. At worst, they would fumble it like my mother's broken toe.
The problem is besides urgent care availability you are subject to doctor availability. Doctors aren't 24/7 nor are most urgent cares.
I wish more would ask that option or partner with urgent cares in the area to make them 24/7 locations. Too many by me aren't 24/7, forcing the issue to the ER.
No but it depends on availability and how valued a patient you are. If you are a new patient, you are waiting and much better suited to urgent care or the hospital depending on availability.
It entirely does.
That was my case with the gallstones. I was moaning in pain from them. I HARDLY do that unless I am in emense pain. I'll just say I have a stomach ache and try to fix it if it isn't major stinging pain like my gallbladder was.
I never said there is no need for Emergency rooms, my remarks were in response to another poster who said: "Plus, the people who have Medicaid will continue to use the ER for routine care so we aren't going to really be saving anything." I said that I don't think the ACA had much to do with that and that people with regular insurance also tend to over utilize emergency rooms but that the reason for that was because ER's like the big bucks they get for treating non emergency illness and that they could triage patients and have those with non critical conditions seen by a Physician's assistant or Nurse Practitioner
But clearly you dont know what they would have paid had you gone to the other facility, i.e. doctors vs hospital. The reimbursement schedule is available for purchase..
It's pretty easy to tell if you have received treatment at both types of facilities, or I suppose you could look up the CMS reimbursement rates to make the comparisons you don't have to pay to access those
I never said there is no need for Emergency rooms, my remarks were in response to another poster who said: "Plus, the people who have Medicaid will continue to use the ER for routine care so we aren't going to really be saving anything." I said that I don't think the ACA had much to do with that and that people with regular insurance also tend to over utilize emergency rooms but that the reason for that was because ER's like the big bucks they get for treating non emergency illness and that they could triage patients and have those with non critical conditions seen by a Physician's assistant or Nurse Practitioner
I agree with that but the problem is time. As I said, had I went earlier enough an urgent care was an option, at best they would tell me to be admitted to the hospital because of the gallstones. The issue is going back into the queue. When you go and you are forced into a nurse practitioner because of a perceived "non-emergency illness" but upon check out it is ruled that, you are now out into the back of the line of you are sent back to the traditional ER line.
Quote:
Originally Posted by Weichert
Sorry, ER costs more than a regular doctor appointment.
It does but u unless you have the ability to get a doctor's appointment that day or have a good comic, it maybe worth the economic cost you pay vs. the opportunity costs of going weeks with it unsolved.
Thats because the hospital would have done DIFFERENT procedures, things like xrays, blood tests, etc that wouldnt have been done at the doctors office.
The reimbursement schedule PER PROCEDURE, is the same..
btw, the other poster wouldnt have any knowledge what it cost their insurance company, only the billed amounts which arent the paid amounts.
That's not true. In our case, our insurance (BCBS) sends us EOBs (Explanation Of Benefits) which list the actual billed amount, the amount the insurance company will pay for the procedure/s and treatment/s (which is ALWAYS less), and what we owe based only on the amount the insurance company will pay for procedure/s and treatment/s, and our copays and remaining deductible.
Example: ER visit, blood test, IV hydration, observation.
Billed amount: $4,925
Insurance will pay: $2,520
Our deductible: $1,500 per person or $3,000 per family, whichever is reached first.
So the hospital had to write off $2,405. We paid about $1,000. Insurance paid about $1,520.
BTW this "other poster" knows exactly what the difference between what the insurance company pays and the billed amount because I get that information in the mail from BCBS.
Ok conservatives tell us how much your premiums were in 2013 and how much they are this year and how much you think they will be if the ACA is turned over.
Premiums were lower, but more to the point of affordability... deductibles were SIGNIFICANTLY lower prior to the ACA.
Read the NY Times poll article:
Quote:
“My employer-paid plan has a $5K deductible, so I don’t get medical services if I can help it,” said Ed, 61, from Winston-Salem, N.C. "I forgo blood pressure meds and colonoscopy,” he continued, even though his last test found polyps that should be monitored. While the Affordable Care Act mandates the coverage of certain screening services at no cost to patients, any resulting treatment means money out of pocket."
I agree with that but the problem is time. As I said, had I went earlier enough an urgent care was an option, at best they would tell me to be admitted to the hospital because of the gallstones. The issue is going back into the queue. When you go and you are forced into a nurse practitioner because of a perceived "non-emergency illness" but upon check out it is ruled that, you are now out into the back of the line of you are sent back to the traditional ER line.
My husband's best friend is a Physician's Assistant and we've talked about these issues with him. At the hospital he works at there is a protocol for ER services, obvious trauma, breathing problems or anything life threatening are given immediate priority, for anything else the patient triaged and seen by an appropriate practitioner. It's called 'dedicated queuing" The other method which is called "pooled queuing" means that everyone is treated by the same trauma team on a first come first serve basis. If a patient who is directed to a NP or PA and they determine that they need care that is beyond their ability to deliver it the appropriate physician is called to see them (they are in the same facility as the ER) or if it is a life-death emergency they go to the head of the line in the ER pool. He likes it and he said that patients like it..someone who needs stitches doesn't have to sit and wait for the ER doc to see 4 babies with ear infections while they sit there bleeding.
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