Headed to the Emergency Room? Read This First


MONTGOMERY COUNTY, TX – With Father’s Day weekend upon us
and July 4th right around the corner, the last thing on people’s
minds is getting hurt or sick. But for those seeking after-hours medical care,
the decisions can be both costly and time consuming.

Primary Care Physician – Average Cost of Office Visit $0
to $150

The primary care physician is always the cheapest and most
effective way to address medical concerns. He/she understands your medical
history and is covered by your insurance plan. Physicians can refer patients to
specialists and will send patients to the hospital when the symptoms indicate
the best course of treatment requires hospital resources.

For patients without insurance, the Lone Star Family Health Center has
locations in Conroe, Spring, Willis, and Grangerland, offering medical services
on a sliding scale. Interfaith Community Clinic
also offers medical services on a sliding scale in the city of Oak Ridge North.

Telemedicine – Average Cost of Virtual Visit $0-$130

Due to the COVID-19 pandemic, most insurance companies allow
their subscribers to use 24/7 telemedicine doctors to refill prescriptions and
treat non-life-threatening conditions such as the flu, rashes, tooth aches,
pink eye, allergies, colds, headaches, skin infections, sinus infections, and sore
throat.

While telemedicine doctors cannot assume the patient’s
overall medical care, they can provide short-term solutions and medications until
your primary care physician is back in the office.

When the insurance company covers the virtual visit, the
patient’s cost is the insurance plan’s copay. The following list is not all-inclusive, but
provides a starting point for 24/7 telemedicine alternatives:

LiveHealth Online
– accepts insurance from Amerigroup

Teladoc – accepts
insurance from United
Healthcare
, Molina
Healthcare
, and various Aetna
plans

American Well – accepts
insurance from United
Healthcare

Doctor on Demand
– accepts insurance from United
Healthcare

MDLive – accepts
insurance from Blue
Cross/Blue Shield of Texas

Each telemedicine service has a cash pay option to allow
uninsured patients access to virtual office visits too.

Urgent Care Facilities – Average Cost of Urgent Care
Visit $0-$250

An urgent care facility is not an emergency room, it is a
doctor’s office setup to handle all non-life-threatening medical conditions,
including accidents, burns, broken bones not requiring surgery, lab tests,
x-rays, bronchitis, respiratory infections, and many others.

In Montgomery County, CareNow
facilities are open 7 days per week with evening hours and accept a wide range
of health insurance plans in locations across
Montgomery County in Conroe, Magnolia, Montgomery, and Kingwood.

For uninsured patients, CareNow also estimates your charges
before they provide treatment and discuss uninsured discounts and options that
may be available to the patient.

Next
Level Urgent Care
also has a location in Conroe open 7 days per week until
9pm that accepts insurance copays and reasonable self-pay rates.

Free-Standing Emergency Rooms – Average Cost of Emergency
Room Visit Varies

Free-standing emergency rooms are not attached to any
hospital and are usually located in high-traffic areas, although they can be
affiliated with a hospital.

While the wait time at a free-standing emergency room is
minimal, all free-standing ERs are not the same. Some do not accept all
insurance plans, which could leave patients with big bills during a medical
emergency.

Before requesting treatment from a free-standing emergency
room, verify your insurance will cover the visit and ask for an estimate of
charges.

Hospital Emergency Rooms – Average Cost of Emergency Room
Visit $2,500-$5,000 (Plus Tests)

Before setting out for a long wait at a hospital ER,
determine if any of the other alternatives can provide the needed medical
treatment. If it truly is a life-threatening emergency call 9-1-1 or proceed
immediately to the nearest emergency room.

While every hospital in Montgomery County provides ER wait
times on their website, those wait times are only from the time of arrival at
the ER to the time the first medical personnel asks questions about your
medical condition. In most cases, the triage nurse takes the patient’s vitals
and chief complaint and asks the patient to wait in the waiting room until they
are called again.

According to HCA Houston
Healthcare Conroe
, “ER wait times on our website are approximate and
provided for informational purposes only. ER wait times represent a four-hour
rolling average updated every 30 minutes and is defined as the time of patient
arrival until the time the patient is greeted by a qualified medical
professional. Patients are triaged at arrival and are then seen by a qualified
medical professional in priority order based on their presenting complaint and
reason for visit.”

Therefore, a patient with an ear infection might have to
wait longer if a patient with chest pain arrives at the ER after them. Thereby,
a vehicle accident with injuries takes precedence over people already waiting
in the ER.

HCA Houston Healthcare Conroe is committed to caring for the
community and encourages patients to “seek out the appropriate level of care as
soon as possible, whether it is a family physician, an urgent care clinic, or
your local ER. If you are having a medical emergency, please call 9-1-1.”

The Future of Emergency Room Visits

In order to reduce the costs of ER visits, United Healthcare and Anthem
have pilot programs
in other states allowing the insurance companies to
deny ER visits when alternative care such as telemedicine and urgent care centers
are available. A patient can visit the ER and the insurance company could deny
payment of the ER visit because the insurance company deemed it “not an
emergency.”

According to Ken Terry with WebMD Health News, the Texas
Medical Association joined the American College of Emergency Physicians in
opposing United Healthcare and Anthem’s policy of deeming ER visits
unnecessary.

Currently, Texans are not subject to insurance control over
ER visits. However, insurance companies are looking for ways to control patient
medical costs. At some point in the future, insurance companies will penalize
patients who use emergency rooms as their personal physicians when telemedicine
and urgent care centers are also available.



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