Calculating the costs associated with the emergency room healthcare provision is truly a complicated task. This is why patients end up in complicated monetary circumstances when they are not able to calculate the cost of their treatment. Emergency room billing further adds to these complications as the cost of emergency treatment depends upon the instantaneous healthcare provision that is given to patients.
However, some ways and methods can be used to navigate through the emergency room billing system, and they are highly effective for both patients and practices as well. This way we have some of our time and effort to publish this guide that will assist you in understanding the emergency room billing calculator and making adjustments accordingly.
An Introduction to Emergency Room Billing
On average, the cost of emergency room healthcare is approximated by UnitedHealthCare (A prominent insurance carrier) to be between $2000-$2500 in the United States. However, these costs can also increase based on the nature of the treatment, and the overall diagnosis that is done. Therefore, it is highly important for patients to be aware of the basics of emergency room billing, so that they can easily navigate their expenses. Such an approach can save them time and money, and contribute to a more aware society as a whole.
How Does the Emergency Department Calculate Costs?
The emergency room billing process begins when you register at the emergency room and pay the triage fee which is normally between $200-$1000. Up next, you will be charged a facility fee when you are assigned a room for treatment, which is around $1100. After this, the physician’s professional fee along with the cost of supplies is incurred according to the nature and duration of treatment along with the usage of any additional supplies.
Acuity (Severity) Level and Its Impact on Emergency Room Cost
Another important factor to keep in mind whilst calculating your emergency room cost is that overall ally depends on the acuity or severity level to assess your severity level, you can judge on a scale from 1 to 5. Usually, patients with level 3 severity have to wait for much more time than the ones with 5 severity levels. This also means that patients with level 3 severity also face higher costs, more than the patient with level 5 severity.
Emergency Severity Index Scale (ESI)?
As mentioned above, the severity of a patient’s medical situation is assessed based on a scale where level 1 represents the most critical conditions requiring severe treatment. Level 3 is considered to be the most common one where most of the patients are treated. These scales for assessing severity levels are outlined below:
|Level 1 (ESI 1)||$1,400-$1500||A problem causing a severe threat to life.|
|Level 2 (ESI 2)||$860-$900||A problem that can cause impairment if not treated and requires urgent attention|
|Level 3 (ESI 3)||$650-$750||A problem that is resolvable with low risks, but can exacerbate if not treated.|
|Level 4 (ESI 4)||$400-$450||A limited health risk that does not have a permanent effect.|
|Level 5 (ESI 5)||$150-$160||Usually, a minor issue that is resolved with a mild treatment|
The Benefit of Charity Care
Some ways can help you decrease your emergency room cost. Some hospitals have many charity care programs. The programs provide support to those patients who are from lower-income backgrounds with specific levels of severity. So in case you do have to visit an emergency room, you can see if you are eligible for this charity care program. If you do manage to apply and gain eligibility, you’ll see that your ER room visit cost will radically decrease.
To conclude, we can say that the emergency room billing calculator depends upon several diverse factors ranging from the level of severity to the location of treatment. Emergency room visits are also under insurance and sometimes co-pay methods are also implemented in many hospitals. However, the average cost is still around $2000, and it can be lowered with charity care programs if you are eligible to attain them.