I’m looking to compare some notes on an issue. We continue to see an increasing number of patients contacting us after they receive a bill for their visit to the emergency department regarding what they consider to be high charges for the services provided. As the patient will often note in their letter or call, the reason for their visit was not a true emergency; therefore, if they had known how much the visit was going to cost they would have attempted to receive care with their primary care provider during office hours.
Under EMTALA (Emergency Medical Treatment and Labor Act), we are prohibited from discussing a patient’s ability to pay prior to completion of a medical screening, and generally, if the facility and clinicians have invested the required time to perform these services, there is often little value to attempting to refer the patient elsewhere for treatment.
Are any providers posting average charges according to the visit level assigned (1-5), or using any other method to make patients aware of the cost of an emergency department visit? We currently do not, and we have some concerns that doing so could be problematic under EMTALA. We appreciate thoughts and comments on this topic.
Answer: In-house counsel should address this question. My response is based on the caveat that my answer should be vetted with legal counsel because I am not an attorney. From an operations standpoint, I don’t see any reason for not disclosing pricing for all patients to see within the process the emergency department (ED) utilizes to triage patients and the option for treatment if a true emergency is not present upon admission.
Many organizations have implemented outpatient clinic settings adjacent to the ED using mid-level practitioners with oversight as an option to reduce both costs to the hospital and respective patients. Again, seek the advice of legal counsel when involving EMTALA.
This question was answered by: David A. Williams, FHFMA, CPA, partner, Horne LLP, and a member of HFMA’s Mississippi Chapter.
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