EVERYTHING YOU ALWAYS WANTED TO KNOW ABOUT EMERGENCY ROOMS… BUT WERE AFRAID TO ASK!

EVERYTHING YOU ALWAYS WANTED TO KNOW ABOUT EMERGENCY ROOMS… BUT WERE AFRAID TO ASK!    By: Nora Johnson

Emergency rooms are actually a department within a hospital-based facility that provides the setting for emergency health care services provided on a 24/7 basis.

What is an Emergency?

The federal government uses the “Prudent Layperson” definition which is: “…a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, with an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:

• Serious jeopardy to the health of the individual or, in the case of a pregnant woman, the health of the woman or her unborn child;

• Serious impairment to bodily functions; or

• Serious dysfunction of any bodily organ or part.

Translated, this simply means that the average person, dealing with a life or death situation, does not have to be a qualified healthcare professional to decide to access emergency room services, and you don’t have to feel guilty, or think you might be legally liable if the patient’s suspected heart attack turned out to be indigestion. 

Federal Law governing Emergency Rooms - EMTALA

From my Truth Is Stranger Than Fiction file:  A caring neighbor found her next-door, lady-friend suffering from chest pain and drove her to the ER.  As soon as the patient was ushered into the ER, the good neighbor was asked to give patient information to the registration desk.  In the spirit of caring cooperation, she reported vital information: patient’s name, address, etc. as well as her own name and contact information.  A month later, our caring neighbor got her friend’s ER bill from the hospital.  When she called to straighten out the mistake, the hospital informed her that her neighbor had no insurance, so the caring neighbor, who signed the admission form, was liable for the bill!! 

Sounds like this hospital's CFO is trying to profiteer from a variation of the world's oldest profession.  The neighbor was in no-way, liable for her friend's bill.

EMTALA is also known as Section 1867(a) of the Social Security Act. It is included as part of the section of the U.S. Code which governs Medicare. EMTALA is an acronym for Emergency Medical Treatment and Active Labor Act and applies to hospitals that participate with Medicare or Medicaid (CMS).

According to Michael Walrath, my favorite Esq., this law prevents hospitals from ‘dumping’ or ‘discriminating’ against patients who either have Medicare/Medicaid, or no insurance.  It prohibits hospitals from denying or delaying care based on a patient’s inability to pay.

Hospital emergency rooms are required by this law to provide “an appropriate medical screening examination” for the purpose of determining if an emergency medical condition exists. If such an emergency does exist, the hospital must either stabilize the patient or transfer the patient to another facility.

Check back for the next blog:

WHAT YOU NEED TO KNOW ABOUT PAYING IN “ADVANCE” FOR EMERGENCY SERVICES.