Everyone hopes they will never have to visit an emergency room. However, accidents and severe illnesses can happen at a moment’s notice, which is why emergency rooms exist. When a sudden injury or illness occurs to you, a friend, or a family member, you may hesitate to go to a freestanding ER because of common myths and misconceptions. For that reason, we’ve debunked these common myths about freestanding emergency rooms.
MYTH #1: “Freestanding Emergency Rooms are not true emergency rooms.”
FACT: The Texas Department of State Health Services enforces very clear licensing rules to ensure that freestanding emergency rooms provide the same level of service and meet the same standards as hospital ERs. Like hospitals, freestanding ERs are required to have an emergency trained physician and registered nurse onsite at all times, must be open 24/7, 365 days a year, and must have the clinical equipment necessary to quickly diagnose and treat emergencies.
MYTH #2: “Freestanding Emergency Rooms purposely saddle patients with surprise medical bills (often referred to as balance billing).”
FACT: Based on patient satisfaction surveys and reviews, the vast majority of freestanding ER patients are well informed about the facility’s billing practices and have no complaints about their bills. However, when patients do get hit with unexpected out-of-pocket expenses, there are two primary causes: predatory underpayment by health insurers and confusion on the part of patients regarding the specifics of their own benefit plans.
Texas law requires insurance companies to reimburse health care providers at the “usual and customary rate” for emergency care. But because there is no definition of the term “usual and customary” nor uniform guidelines for insurance companies to follow, insurers have determined their own arbitrary rates and unilaterally declared them to be “usual and customary.” While some insurers provide adequate reimbursement for services, others are reimbursing at a much lower percentage. This leaves freestanding ERs with few options. They can either accept the low reimbursement rate, appeal to the Texas Department of Insurance, or collect the remaining balance from the patient.
MYTH #3: “Unlike hospital ERs, freestanding emergency rooms are not required to treat all patients.”
FACT: Freestanding ERs provide critical access to care for any patient that walks through their door, regardless of insurance or ability to pay. This includes Medicare, Medicaid, and uninsured patients. Just like a hospital-based ER, freestanding ERs are legally required to administer medical screenings and stabilize all patients at their facility. Freestanding ERs provide millions of dollars in uncompensated care annually, serving as an important resource to their local communities.
MYTH #4: “Freestanding emergency rooms price gouge consumers by intentionally misleading them into thinking they are at an urgent care facility.”
FACT: Freestanding ERs provide high quality emergency care for medical emergencies. Furthermore, the Texas Legislature created clear guidelines for freestanding ER operators and comprehensive regulations to ensure freestanding ERs provide the same levels of service as hospital-based ERs. Each freestanding emergency room facility has both external and internal signage prominently displaying the word “Emergency,” postings outlining the available levels of services, and billing disclosures that patients are required to sign acknowledging they are in an emergency room setting. It is also important to note that only licensed emergency care facilities are allowed to use the word “emergency” in their name or marketing material.
MYTH #5: “Freestanding emergency rooms increase the cost of health care.”
FACT: According to a 2010 University of Michigan study, the average cost of an admitted patient is $35,000 per case. Preliminary research suggests that freestanding ERs may help to reduce inpatient admission rates. By treating patients in a freestanding ER setting and transferring only patients in need of inpatient care, freestanding ERs can improve overall efficiency and help save on health care costs. Freestanding ERs have no financial incentive to push patients into hospital admissions, and so can serve as unbiased gateways into the healthcare system.
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About Five Star ER
Five Star ER is locally owned and operated by the physicians of Emergency Service Partners, a respected provider of emergency physician services to hospitals and health systems across Texas for nearly 30 years. Our experienced physicians bring their excellent tradition of emergency care to a first-class, patient-centered freestanding ER.
Our patient-centered care means you will come first. Our freestanding ER provides the capabilities of a hospital emergency department, without the hassles and long waits that can be part of a hospital ER. From the comfortable lounge area and private exam rooms to our top-notch medical team and latest technology, patients can be door-to-doctor in less than 15 minutes. Find the location nearest you.
This content was created to be purely educational in nature. This post is not meant to be used as a substitute for medical treatment or personal consultation regarding a medical condition. As always, if you or a loved one is suffering a life-threatening medical emergency or injury, call 911.