United Healthcare will no longer cover uncecessary ER visits

[Anonymous]

Well are they going to give customers a clearly defined list of items that should be seen at urgent care only?

[Anonymous]

As a United customer, I have zero faith that this will be implemented in any way that will be reasonable or not suck for patients. They are the absolute worst.

[Anonymous]

Anonymous wrote:What do you do if you get a nasty cut? Do you need to go to an ER for stitches or can it be done at an urgent care place? How in the hell would a regular person know this kind of cut/wound needs an ER visit, while this size cut can be done at an urgent care clinic. Oh, I'm sure UHC would argue that you could have gone to the urgent care clinic because your wound was only X cm long instead of Y cm.

That's definitely an urgent care. Unless you cut your arm off or you see bone, go to urgent care. It should be obvious from the amount of blood whether you need ER or urgent care. Urgent care can do stitches and can help you clot.

But if it's on my face, I'm seeing neither and having a dermatologist stitch me up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I sense a lot of ER doctors leaving united's network and just billing patients personally

This is ignorant. ER docs have a salary.

It’s the hospital corporations that get $$$$$ from expensive ER visits.

ER docs have a salary paid by an employer who is almost never the hospital. Most hospitals contract out their ERs. Those companies now have a lot of incentive to be out of network

Uh they aren't salaried the ones I know are paid by the number of patients they see. And yes hospitals contract out to SHITTY companies who have terrible benefits. I know a mom on maternity leave who is getting ZERO maternity leave or payment from her employer.

On another note, I've seen SO many ER visits along the lines of "I have had this lower back pain for about 4 months, but I've decided at 2am on a random day, it's a good idea to take an ambulance to the ED." Ok buddy, NOT an emergency.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I sense a lot of ER doctors leaving united's network and just billing patients personally

This is ignorant. ER docs have a salary.

It’s the hospital corporations that get $$$$$ from expensive ER visits.

ER docs have a salary paid by an employer who is almost never the hospital. Most hospitals contract out their ERs. Those companies now have a lot of incentive to be out of network

And hospital corporations have way more power than “employer” to decide who they will contract with. If your talking about locums, that is not the norm for the majority of employees at most hospitals.

Either way the original poster of this back and forth stated ER docs would begin billing personally. That is false.

And this is a good change. There is too much waste in the ER with non-emergency visits. They train for emergencies and prefer them. They don’t want to be a primary care doctor.

This will ease the strain on our healthcare system and should be the case across the board in order to ease taxpayer dollars.

If it can wait until your primary care is open, wait. If it can’t but isn’t ER/Ambulance worthy, go to urgent care.
If you suspect life and death or severely broken bones, go to the ER.

[Anonymous]

Anonymous wrote:The problem with this is that it will not hit the pocketbook of the person who is inappropriately using the emergency room. The provider, who by federal law is required to perform an assessment, will not be reimbursed, but by contract will not be able to balance bill the patient.

+1 the ER abusers are mostly uninsured. This is just United being cheap as usual.

[Anonymous]

Anonymous wrote:The symptoms for a heart attack and a panic attack can be identical.

I have gone to the ER twice thinking it was a heart issue when it turned out to be a panic attack. I suffer from severe PTSD, anxiety and depression. You are absolutely right!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I sense a lot of ER doctors leaving united's network and just billing patients personally

This is ignorant. ER docs have a salary.

It’s the hospital corporations that get $$$$$ from expensive ER visits.

ER docs have a salary paid by an employer who is almost never the hospital. Most hospitals contract out their ERs. Those companies now have a lot of incentive to be out of network

And hospital corporations have way more power than “employer” to decide who they will contract with. If your talking about locums, that is not the norm for the majority of employees at most hospitals.

Either way the original poster of this back and forth stated ER docs would begin billing personally. That is false.

And this is a good change. There is too much waste in the ER with non-emergency visits. They train for emergencies and prefer them. They don’t want to be a primary care doctor.

This will ease the strain on our healthcare system and should be the case across the board in order to ease taxpayer dollars.

If it can wait until your primary care is open, wait. If it can’t but isn’t ER/Ambulance worthy, go to urgent care.
If you suspect life and death or severely broken bones, go to the ER.

You’re assuming people know their sprained pinkie isn’t an emergency

[Anonymous]

Anonymous wrote:

Anonymous wrote:The problem with this is that it will not hit the pocketbook of the person who is inappropriately using the emergency room. The provider, who by federal law is required to perform an assessment, will not be reimbursed, but by contract will not be able to balance bill the patient.

+1 the ER abusers are mostly uninsured. This is just United being cheap as usual.

I don't see why the ER can't turn away patients and force them to the urgent care across the street. Being uninsured shouldn't matter. The law needs changed because it's bankrupting our hospitals and driving up costs on everything else in a hospital (like routine surgeries or childbirth)

[Anonymous]

Anonymous wrote:

Anonymous wrote:The article references things like pink eye. Do people really go to the ER for pink eye?

I think the heart attack/panic attack would be covered as it could be something ER-worthy.

I had bacterial pink eye, it came on while I was asleep and when I woke up the goop was so bad that I’d wipe my eyes and 3 minutes later I’d need to do it again because I couldn’t see. I walked to CVS, got in line for minute clinic. When the NP saw me she said “nope that’s outside what I can do. Go to urgent care or the ER.”

In my case, I had Uber on my phone, and at that point could see for a minute or two at a time so I could order one and went to Urgent care, but in other circumstances, I would have needed to go to what’s in walking distance.

So, yeah pink eye can be bad.

I have a friend with similar insurance whose kid woke up screaming that his chest hurt. Eventually diagnosed as heartburn and the claim was denied.

Goop in your eye sucks, but it’s not a life threatening emergency.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The article references things like pink eye. Do people really go to the ER for pink eye?

I think the heart attack/panic attack would be covered as it could be something ER-worthy.

I had bacterial pink eye, it came on while I was asleep and when I woke up the goop was so bad that I’d wipe my eyes and 3 minutes later I’d need to do it again because I couldn’t see. I walked to CVS, got in line for minute clinic. When the NP saw me she said “nope that’s outside what I can do. Go to urgent care or the ER.”

In my case, I had Uber on my phone, and at that point could see for a minute or two at a time so I could order one and went to Urgent care, but in other circumstances, I would have needed to go to what’s in walking distance.

So, yeah pink eye can be bad.

I have a friend with similar insurance whose kid woke up screaming that his chest hurt. Eventually diagnosed as heartburn and the claim was denied.

Goop in your eye sucks, but it’s not a life threatening emergency.

Right! Urgent care was definitely the right place for you. You'd likely have been triaged in the ER and waited for hours and hours because they don't care about pink eye. When mine was that bad I just made a doctor's appointment and was seen that day and got my eye drops...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem with this is that it will not hit the pocketbook of the person who is inappropriately using the emergency room. The provider, who by federal law is required to perform an assessment, will not be reimbursed, but by contract will not be able to balance bill the patient.

+1 the ER abusers are mostly uninsured. This is just United being cheap as usual.

I don't see why the ER can't turn away patients and force them to the urgent care across the street. Being uninsured shouldn't matter. The law needs changed because it's bankrupting our hospitals and driving up costs on everything else in a hospital (like routine surgeries or childbirth)

How would that help? That's not going to change whether people pay, it will just switch the burden of non-payment from one provider to another.

[Anonymous]

Urgent care is also not always open or available. I went to the ER once for an ear infection, because it was Christmas Day and everywhere else was closed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I sense a lot of ER doctors leaving united's network and just billing patients personally

This is ignorant. ER docs have a salary.

It’s the hospital corporations that get $$$$$ from expensive ER visits.

ER docs have a salary paid by an employer who is almost never the hospital. Most hospitals contract out their ERs. Those companies now have a lot of incentive to be out of network

Uh they aren't salaried the ones I know are paid by the number of patients they see. And yes hospitals contract out to SHITTY companies who have terrible benefits. I know a mom on maternity leave who is getting ZERO maternity leave or payment from her employer.

On another note, I've seen SO many ER visits along the lines of "I have had this lower back pain for about 4 months, but I've decided at 2am on a random day, it's a good idea to take an ambulance to the ED." Ok buddy, NOT an emergency.

WTAF? No. It's a salaried position. It's not fee for service. https://www.salary.com/research/salary/benchmark/er-doctor-hourly-wages

At what ERs do you think docs are paid by the number of patients? You don't have to name specific docs, just at least one ER that can then be confirmed -- because this is a frankly ludicrous claim.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem with this is that it will not hit the pocketbook of the person who is inappropriately using the emergency room. The provider, who by federal law is required to perform an assessment, will not be reimbursed, but by contract will not be able to balance bill the patient.

+1 the ER abusers are mostly uninsured. This is just United being cheap as usual.

I don't see why the ER can't turn away patients and force them to the urgent care across the street. Being uninsured shouldn't matter. The law needs changed because it's bankrupting our hospitals and driving up costs on everything else in a hospital (like routine surgeries or childbirth)

Hospitals in major metro areas are seeing huge profits. The ones struggling are the rural ones reliant on Medicaid - this won’t change that dynamic at all