EMCare bills emergency patients at Glen Rose Medical Center at out of network insurance ratesSomervell County Salon-Glen Rose, Rainbow, Nemo, Glass....Texas


EMCare bills emergency patients at Glen Rose Medical Center at out of network insurance rates

17 May 2015 at 1:33:22 PM

from Somervell County Hospital District Budget and Finance Committee Meeting 4/28/2015 Agenda

Rough transcript: To hear exactly what was said, please watch the video

Honea: The question has been brought up in the past and y'all might get it as well.. on the insurance for ER physicians and it bills under Fossil Rim. Fossil Rim Physicians is who the billing group is there. They bill out of network for most insurance. We did contact them a while back and we could expand the insurances that are covered in the ER but it's going to cost about $200,000 a year. Reynolds.... our subsidy would increase significantly. 

(What subsidy is this? The Glen Rose Medical Center subsidizes Emcare if they do not get enough people that use the emergency room)

Parker: That would cover all the providers. Are there some that are cheap and some that aren't? 

Reynolds: No, they all pay about the same. We do have some that are in network. They're in network with medicare. Most of the providers, they're not in network. If you're in network, you have to accept what insurance pays. You're out of network, even if insurance pays, you can bill the patient for the additional amount. 

Harper: So the power plant and school Are they considered in network or 

Reynolds. I don't know, depends on who their insurance is with. Insurance by insurance not employer

Harper: So, Luminant has different insurance policies

Reynolds: Some of them could be in network and some not

Parker: The $200,000 it would take to be in network for everybody, is that equally distributed amongst a thousand different insurance companies?

Honea: We would have to pay an additional 200k to Emcare to put those people in network because right now billing out of network they're making more money, so basically we're supplementing them. It would be cheaper on the patients but we're actually absorbing that patient cost that they're getting for billing out of network to the patients. 

Reynolds: if we could build our volume (up visits) it would be a wash for us. Wouldn't cost us anything

Parker: (Joke about getting more people to visit the emergency room)

Honea: Looking at the bill, it really is a significant amount of money 

Reynolds. Probably the complaint we get the most on is insurance being out of network for 

Parker: The administrative fee is paid to Emcare.Emcare administers Fossil Rim physicians All Emcare does is billing for the physicians. Billing for everything else is us?

Reynolds: Right. 

Honea: You're going to get a bill from the doctor and a bill from us.

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