Headed To The Emergency Room? Read This First

Montgomery County Gazette

Sherrie Shorten/Montgomery County Gazette

By: Sherrie Shorten

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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The Montgomery County Gazette is an online newspaper serving the needs of the citizens of Montgomery County, Texas. While we cover news on the national and state level, we primarily focus on providing accurate and up-to-date local news and events. The Montgomery County Gazette aims to restore journalistic integrity to the media by not interpreting the news, but reporting the news. This is an added benefit to the residents of Montgomery County in delivering them news that is accurate, informative, and unbiased. Founded in 2015, the Montgomery County Gazette has grown exponentially from a simple Facebook page to this website. We are dedicated to the community because not only do we cover Montgomery County, we live here too.

Splendora, TX

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