Know the difference for insurance reasons

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LAKEWOOD, Colo. (KDVR) – These days, you have the choice between a standard urgent care facility or a stand-alone emergency department. It is important to know the difference, as your insurance company charges and will charge accordingly.

Cathy Crynes went to Sweden’s Belmar Medical Center after injuring her wrist. She said that after receiving treatment, she discovered a bill for over $5,000.

“There should be at least some type of discussion that if you enter this building, you enter at your own risk and you need to be prepared for what his bills might be,” she said. .

Crynes asked FOX31 troubleshooters to help them get an itemized bill, which the Swedish medical center quickly provided.

Crynes told FOX31 that she then contacted her insurance company. His bill and $500 deductible were reduced.

“I’m thrilled, I’m so grateful,” she said.

Swedish released a statement to FOX31 explaining that “our emergency departments and FSEDs are clearly marked as such and provide a different level of care than an urgent care facility.”

Swedish points out that all prices are competitive and adds that “how much patients actually pay for emergency services has more to do with the type of insurance coverage they have than with ‘prices’ or ‘fresh’ from the hospital”. The full statement is included below.

Experts say it’s important to understand the type of service and billing to the nearest urgent care center before an emergency occurs. Copayments and other fees may be based on the type of establishment you visit.

Statement from Swedish Medical

“At Swedish Medical Center, our Emergency Departments and Freestanding Emergency Departments (FSEDs) help us meet the needs of the community for emergency care near us and all of our emergency rooms are staffed certified emergency physicians. Our emergency departments and FSED are clearly marked as such and provide a different level of care than an urgent care facility. Additionally, EDs and FSEDs do not turn anyone away based on their ability to pay, while some urgent care clinics may not accept Medicaid or those without financial resources. The Swedish Medical Center aims to serve the community and provide the highest level of care when needed.

How much patients actually pay for emergency services has more to do with the type of insurance coverage they have than hospital “prices” or “fees”. Our prices are competitive and vary depending on a number of factors, including the patient’s medical condition, the expertise of the physicians, and the technology and equipment used to provide the care. We do not determine a person’s deductible or coinsurance; this is determined by their health insurance. Level of care designation is based on specific billing codes as well as guidance provided by the Centers for Medicaid and Medicare.

The move to higher deductible insurance plans has put a strain on many of our patients, but we understand their choice to pay a lower monthly premium, and we also understand their frustration with the larger out-of-pocket they may suffer as a result. Swedish Medical Center always works with patients on all billing requests and offers our patients flexible options such as payment plans.

We also believe that consumers should consider many factors when making health care decisions, which is why we provide education about appropriate access points for care on our website. We are also proud to have partnered with the Colorado Hospital Association on an important community education initiative to educate Coloradans about their health care options before they have an unexpected health need. You can find out more about this partnership at WhereForCare.org.”

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