Emergency Room Services At-a-Glance
Posted on November 12, 2015
Many of us, at one time or another, have had the experience of visiting the emergency room (ER). In addition to being poked and prodded by all the doctors and nurses in the ER, there’s also a possibility of having to stay in the hospital for further evaluation.
Did you know?
Even if you stay in the hospital overnight because of your ER visit, you might still be considered “outpatient” (a patient who receives medical treatment without being admitted to a hospital).
Sometimes you are kept in observation status while you are in the ER to help the doctor decide if you need to be admitted as inpatient or if you can be discharged. In these cases, you’re considered outpatient even if you spend the night at the hospital. You can be in observation status for a few hours or a few days (usually 48-72 hours). You may be taken to an observation area for some time or even sent to your own room. Many people are unaware that being “observed” during an ER visit is not the same as being “admitted.”
The decision for inpatient hospital admission is based on your doctor’s judgment and your need for medically-necessary hospital care. You are considered inpatient when you are formally admitted to the hospital with a doctor’s order. The day before your discharge is your last inpatient day.
Understanding your hospital bill
When it comes to understanding the amount you are responsible for when you receive your hospital bill, your hospital status will determine how much you pay for hospital services. If you are kept in observation status, you will be responsible for your emergency room cost sharing (copay and/or deductible). If you are admitted as inpatient, your ER cost sharing is waived and you will be responsible for your inpatient cost sharing (copay and/or deductible).
We recommend that you review your benefits package to determine your out-of-pocket expenses in the event you should ever require these services.
If you have questions about an ER visit, feel free to contact HNE Member Services, Monday – Friday, 8:00 a.m. – 6:00 p.m., at (413) 787-4004 or (800) 310-2835. For TTY/TTD: (800) 439-2370.
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