When a patient visits an emergency department Parkview may charge an emergency department fee for their care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
Parkview follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fees may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The Federal Emergency Medical Treatment and Labor Act (EMTALA) forbids staff or providers in an emergency department from discussing prices or insurance coverage until after a patient has been medically screened by a physician.
The emergency department charges two types of fees, a facility fee and a professional fee. These fees are exclusive of other charges for services that may be provided. These other charges are laboratory, radiology, supplies and drugs.
When a person visits an emergency department, they are charged a facility fee. This fee provides for nurses, support staff, pharmacists, security, equipment and any other things a person needs in the ER as well as the costs for keeping these services available 24 hours a day. The facility fee is based on the complexity of the patient’s condition, tests and treatments provided and whether or not prescriptions were provided.
A professional fee is the charge a physician or other professional provider charges for their expertise and training. The charge covers that provider’s knowledge, training and decision making skill.