In the midst of an emergency, would you go to the nearest emergency room for help or put your health at risk by traveling across town to a hospital that is covered by your insurance?
This is the dilemma many people face in these high risk situations when looking for medical attention, and this is what health insurance agencies are debating with freestanding emergency centers across the state.
A local freestanding emergency center, Star ER gave EverythingLubbock.com documents that show local insurance agencies advising their clients against using these facilities.
“They are creating a lot of misunderstanding in regards to in-network versus out-of-network status,” Star ER CEO Dr. Ryan Lewis said. “We’ve seen a lot of these insurance companies tell their employees do not go to a freestanding or do not go to emergency centers that are freestanding emergency centers that are out-of-network when in fact what they’re not telling us the rest of the story.”
Lewis said state law gives all residents legal right to go in-take coverage at any emergency center for an emergency.
However, a couple local health insurance agencies argued that some people might abuse the law when classifying what an emergency is. They recommend going to in-network facilities for regular medical care.
“It’s extremely scary and it’s downright dangerous and misguided,” Dr. Lewis said in response to that argument.
The American College of Emergency Physicians ranked Texas as the 47th state for providing access to emergency care. Lewis added it is dangerous to direct patients past the closest ER due to financial reasons that are not accurate to begin with.
While some insurance agencies claim these facilities can overcharge their clients, Lewis states that Star ER has never balanced a bill and welcome any evidence that argues otherwise. However, some insurance agencies claim these facilities can overcharge their clients.
“What we’ve seen with the growth of freestanding emergency centers as an additional model is patients have additional access,” Lewis said. “What that has led to is insurance companies having to process more claims because more people are available or have the availability of emergency care in their time of need. Now they’re mad at it and they’re trying to point fingers at us when the fact is freestanding emergency centers process at in-network rates by law for the facility fee.”
The Texas Association of Freestanding Emergency Centers said they have filed numerous complaints to the Texas Department of Insurance on this discrimination and false information. They have asked for stronger regulation, policing, and higher transparency for insurance agencies.
TAFEC is also taking their position to state legislation to ask lawmakers to review budget provisions.
Star ER welcomes anyone with questions to come in and speak with a representative or go to their website for their rules, regulations, and billing at starermergency.com. Or visit their Facebook page here.