Moneyish: How to Avoid Getting Burned at the Emergency Room this Thanksgiving
Don’t let a medical emergency table your Thanksgiving fun — or worse, leave you with thousands in leftover debt.
Almost 37,000 people across the U.S. went to emergency rooms on Thanksgiving Day 2016, according to the U.S. Consumer Products Safety Commission, as preparing the holiday feast tends to come with a side of cuts and burns, while overindulging on rich foods and booze encourages falls, food poisoning and car accidents. And the Consumer Product Safety Commission also estimates that an average of 1,800 cooking fires occur on Thanksgiving Day each year — three times the number on any other day of the year.
“Thanksgiving is one of the busiest days of the year for all urgent care centers,” said Dr. Katharine Miao, medical director of the Metro-North region of CityMD, a network of urgent care centers in New York and New Jersey. “This is a year-over-year event. A lot of people are cooking things they don’t normally cook. We see people using knives that haven’t been sharpened, utilizing immersion blenders and tolls they are not comfortable or familiar with, and doing it hastily … so there’s a rush of cuts and burns and other types of injuries.”
And the medical bills stemming from such emergency care can be hard to swallow. A 2013 National Institute of Health study put the median cost of an emergency room visit at $1,233. If you have insurance, a co-pay for emergency room services is generally $50 to $100, but a trip to the ER without insurance can run anywhere from $150 to $3,000 out-of-pocket, depending on the severity of of injury or illness as well as the ER’s own facility fee. Of course, reports of charges in the tens of thousands abound, particularly when critical care was necessary.
So Moneyish spoke with health care experts and emergency physicians for tips on avoiding the ER this Thanksgiving, as well as tips for trimming your medical bill if you have to check in.
TO AVOID GETTING HURT
Know your options. “The emergency room is probably the worst place you want to be during the holidays, when we talk about how overcrowded it’s going to be, and how it’s likely to be understaffed and result in long wait times. But there are absolutely other options available,” said Kim Buckey from DirectPath, which promotes health care transparency. The ER is for life- and limb-threatening situations; an urgent care center or walk-in clinic can handle the rest. “CVS and Target and Walmart have retail clinics where you can walk in and get seen for the more minor issues, like an earache or the flu,” added Buckey. “And urgent care centers are popping up all over the place … which are set up to handle more serious issues, like possible breaks or sprains, or severe burns or cuts. You’ll be in and out of these faster, and they cost you far less than going to the ER.”
For example, the co-pay for most people with insurance who go to CityMD is around $20, compared to $50 to $100 at most ERs. You can see your emergency room co-pay and urgent care co-pay on your health insurance card. “My ER co-pay is something like $300, and my urgent care co-pay is $50, which is a significant difference,” said Dr. Miao.
Make a medical emergency plan. As you’re going over your Thanksgiving menu or travel plans one last time, take 10 minutes to map out your nearest walk-in clinics, urgent care centers and emergency rooms in case something goes wrong. Check what hours they will be open on Thanksgiving and the day after. And check your local hospitals to see which ones are in your insurance network, and which ones are not. “Sometimes, where you’re in an ambulance, they’ll ask you where you want to go,” said Buckey — so make sure you direct EMTs to a place where you’ll be covered. It’s also smart to write up a list of medications you are on, including over-the-counter ones, which you can tuck into your wallet to show medical staff.
IF YOU NEED MEDICAL HELP
Determine whether it’s a real emergency. Studies have shown that anywhere between 4.8% and 90% of emergency room visits are “avoidable,” meaning they did not end up needing any diagnostic or screening services, procedures or medications, and the patients were sent home. For a cut, Dr. Miao says, “If it’s deep — you see a significant amount of tissue that goes beyond the dermal (skin) layer — or if it doesn’t stop bleeding, a medical professional needs to look at it.” For burns, go get checked out of it blisters, is on a sensitive area such as your face, or if it covers a large area of the body.
As for an upset stomach from drinking too much or food poisoning, Dr. Michelle Lin, an emergency physician at Mount Sinai Health System in Manhattan, suggests that you come in if you can’t keep water or fluids down. Regarding sprains and falls, if you can’t walk at all on their bum foot or leg, or you feel nausea or a headache that won’t stop after banging your head, the come get help. And anyone over 60 who falls and hits their head should get checked out. You should also get heartburn or indigestion checked out if you normally don’t experience these symptoms, or if you have a heart condition. If someone drinks too much, don’t let them drive home. They should be OK as long as they are responsive, but check them in “if they are really not waking up or responding if you rub them hard or push them,” said Dr. Lin.
Drive yourself. Riding in an ambulance can cost upwards of $1,000. “Certainly if you or a loved one is having a real medical emergency, like a heart attack or bleeding profusely, call an ambulance and get to the ER,” said Buckey. Otherwise, “drive (or have someone drive you) or take an Uber — absolutely avoid the ambulance if you can.”
Question procedures, tests and medications. “It’s OK to advocate for yourself,” said Buckey. “Let’s say they are sending you for a CAT scan. You can ask, ‘What are you looking for? Is there a less expensive version of this test?’ Or ‘Is there a generic (cheaper) version of this medication?’” After all, generic drugs can cost 80% to 85% less than an equivalent brand name drug, according to the FDA. Dr. Lin also assured that it’s fine to ask questions. “Saying, ‘What is this test for? How long do you think it’s going to take?’ is totally understandable,” she said. “It’s important that patients understand what is happening to them and why we are doing things.”
AFTER YOUR ER/URGENT CARE VISIT
Study your bill. “Don’t pay it until you look to see whether there is a line on there that says your insurance paid X-amount,” said Buckey. “Sometimes they will neglect to file a claim with your insurance company. Or if you’re covered by more than one source, they may not have submitted a claim to all insurers.” And wait for an of explanation benefits from your insurance company before paying anything, and make sure what they have agreed to cover lines up with what’s on your medical bill. If you notice what your insurer is saying doesn’t line up with what the hospital is saying, call their billing department and talk it through. But be polite! “Rather than saying, ‘You billed me the wrong amount,’ you get much farther by trying to be cooperative: ‘I see a discrepancy here, and I would like to get to the bottom of this,’” suggested Buckey.
Request a detailed bill. You can also request a detailed bill that lists everything that was done to you, and every medication that was given to you, to make sure you aren’t being charged for something that you weren’t given. For example, Buckey cited a bill saying you received surgery for a broken wrist, when all they did was put a cast on you. Send a letter to the hospital by certified mail, and call the billing department. “Explain that you never received this service, and see if they’ll take it off or negotiate it with you,” she said. “If you are not getting any progress with the billing department, then it’s time to go to your insurance company; ask for appeals or grievances department, and they will speak up on your behalf.”
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(Nicole Lyn Pesce is a senior reporter for Moneyish.)