THE TYPICAL EMERGENCY ROOM VISIT

CHARGES, WAIT TIMES, & TIPS FORAVOIDING HIGH COSTS

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Of the approximately

2.6 trillion dollars that are spent on health care in the United States each year (an amount that continues to rise), some estimates suggest that emergency care accounts for up to 10% of the total.

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According to an NIH-funded study, the median ER visit across the U.S. costs $2,168. That’s about 40% more than what the average American pays in monthly rent.

However, the same study found

that the di�erence between the

25th and 75th percentile of

charges was $1,957; this means

many patients are paying a lot

more or lot less than that for an

ER visit, which makes it nearly

impossible to know how much

you will be billed.

The study also outlined thedi�erences between minimum and maximum charges for various health issues.

REFERENCES

Alderman, L. (2010, August 6). Demystifying, and maybe decreasing, the emergency room bill. The New York Times. Retrieved from http://www.nytimes.com/ 2010/08/07/health /07patients.html?_r=1

Caldwell, N., Srebotnjak, T., Wang, T., & Hsia, R. (2013, February 27). “How much will I get charged for this?” Patient charges for top ten diagnoses in the emergency department. PLOS. Retrieved from http://journals.plos.org/plosone/article?id= 10.1371/journal.pone.0055491

Fernandez, E. (2013, February 27). How much will I be charged at the emergency room? UCSF study examines wide range of ER bills, highlights need for better-informed patients. University of California San Francisco. Retrieved from http://www. ucsf.edu/news/2013/02/13576/how-much-will-i-be-charged-emergency-room

Groeger, L., Tigas, M., & Wei, S. (2015, January 14). ER wait watcher: Which emergency room will see you the fastest? ProPublica. Retrieved from http://projects.propublica.org/emergency/

Lee, M. H., Schuur, J. D., & Zink, B. J. (2013, April 26). Owning the cost of emergency medicine: Beyond 2%. Annals of Emergency Medicine, 62(5), 498-505. DOI: http://dx.doi.org/ 10.1016/j.annemergmed.2013.03.029

Preidt, R. (2014, November 25). ER visits on the rise, study reports. Medline Plus. Retrieved from http://www.nlm.nih.gov/medlineplus/news/fullstory_149653.html

Sandler, M. (2015, January 17). ER visits still rising despite ACA. Modern Healthcare. Retrieved from http://www.modernhealth-care.com/article/20150117/NEWS/301169969

Spross, J. (2012, December 14). Over one in three Americans forgo health care due to costs. Think Progress. Retrieved from http://thinkprogress.org/health/2012/12/14/1337261/one-in- three-put-o�-care/

presented by:

The number of emergency room visits has been rising.

Across the United States, patients spend an average of 24 minutes waiting in the emergency room before seeing a doctor, and 2 hours, 13 minutesat the hospital before being sent home.

In 2012, 33% of Americans said they had to put o� medical care for themselves or their family due to cost.

PRESENTS:

HOW TO Avoid High Emergency Room Costs

ALL OTHER U.S. HEALTHCAREEMERGENCY CARE SPENDING

From 2012–2013, the 24 busiest emergency rooms in the United States reported 18.7% more visits.

From 2010–2011, visits increased from 130 million to 136 million.

+18.7%2010

2011

130,000,000

136,000,000

ABDOMINAL PAIN

RESPIRATORYINFECTION

SUPERFICIAL INJURY

SPRAINS & STRAINS

Although di�erent regions of

the United States have di�erent

common reasons for ER visits,

abdominal pain, respiratory

infections, superficial injury,

and sprains/strains are the

four most common reasons

that people visit emergency

rooms across the country.

: : 0 00 0 2 4

: : 0 01 30 2

$500

$1000

$1500

$2000

$2500

AVERAGEER VISIT IN

THE U.S.

AVERAGEMONTHLY RENT

IN THE U.S.

YOUR BILL?

PERCENTILE OF EMERGENCY ROOM CHARGES

250 50 75 100

$1,957 $?$?

UTI

SPRAINS

HEADACHES

The minimum charge for people diagnosed with sprains or strains was $4, while the maximum charge was $24,110. For those diagnosed with headaches, the minimum charge was $15 while the maximum was $17,797. For those diagnosed with a urinary tract infection, the minimum charge was $50 while the maximum was $73,002.

For those without insurance, 55% said they had to put o� health care.

For those with private health insurance, 30% said they put o� health care.

For those with Medicare or Medicaid, 21% said they put o� care.

$50 $1000 $5000 $10,000 $25,000 $75,000

33%

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First of all, it’s important to know that the charges billed are not actually what most people pay; Dr. Jesse M. Pines, an associate professor of emergency medicine and health policy at the Center for Health Care Quality at George Washington University explains, “the prices on the bill are just a starting point… [they] don’t represent what the insurer or patient will ultimately pay.”

TIP #1: Only go to the ER if you need to

Approximately half of emergency department visits are

not for emergencies. One way to avoid the high costs of

going to the ER is to call your doctor first and ask for

advice if your situation is not actually an emergency;

alternately, you could go to an urgent care center, which

is usually faster and cheaper than using an ER.

If a health care professional suggests or orders a test or procedure

during your visit, ask about its benefits and risks—and ask if it is

completely necessary or if there are alternatives.

TIP #2: Be an advocate for yourself in the ER

TIP #3: Review and ask about your bill

Mistakes in billing happen regularly. Duplicate charges,

charges for canceled tests/procedures, and unreasonable

charges for time spent in a room (when you are admitted at

11:00 PM on Tuesday, discharged at 3:00 AM on Wednesday,

and billed for two full days) are all fairly common.

TIP #5: Don’t wait to dispute your bill

Billing takes time, and payment is expected promptly. If you

wait to contact a hospital about your bill, they may report it

to a collections agency, which can ultimately a�ect your

credit score and cost you a lot more in the long run due to

your damaged credit.

As is clear from the information above, the amount that hospitals

and doctors charge varies widely, and hospitals know this. You can

definitely negotiate your final bill. Some hospitals o�er discounts

for cash payment or other payment options if you don’t have

insurance. You can also call the individual doctors who saw you

during your visit and negotiate with them. You can even negotiate

if you have insurance.

TIP #4: Negotiate your bill

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