With many patients experiencing confusion after an emergency room visit, this guide aims to outline key facts about the billing process.
Separate Billing Explained
ER Consulting Inc. operates as an independent doctors’ practice, which means that billing for emergency doctor services is separate from hospital charges.
Patients may receive different accounts for:
- Emergency clinical services provided by ER Consulting Inc.
- Hospital admission and facility fees
- Services from medical specialists, allied healthcare providers, radiology services, and laboratory services
Medical Aid Claims And Responsibilities
While ER Consulting Inc. submits claims to medical aid schemes on behalf of patients, it is important to note that the patient or guarantor remains responsible for settling the account in full. Patients are encouraged to follow up with their medical aid if any delays or shortfalls occur.
Patients’ bills are influenced by whether the funder has a network agreement in place with ERC or not. In cases where a network agreement is in place, there is no co-payment applicable as medical aid rates apply according to SAMA guidelines. Where medical savings accounts have been depleted, the member is liable for the full amount.
Where no network agreement is in place with the funder and ERC, the fees charged by ERC may be higher than what is covered by the funder, and the member may be liable for the difference. Where medical savings accounts have been depleted, the member is liable for the full amount.
There are no network agreements in place with insurance-based products. Members are advised to contact their insurers.
Unfunded (Private Patients)
Private patients are billed at the same rate as medical aids where no network agreements are in place. The fees charged are available upon inquiry at the emergency room reception. The patient or their guarantor is liable for all fees charged.
Understanding The Full Scope Of Your Bill
After an emergency room visit, patients may receive multiple bills for different aspects of their care:
Hospital Services: Charges may include a facility fee for use of the emergency unit, medical supplies, and equipment.
ER Doctor Services: Billed by ER Consulting Inc., this includes the consultation, and any procedures performed. Orthotic devices such as splints or braces (where available) are charged separately. The bill is compiled based on the clinical acuity of the patient, as well as procedures performed, and is not a single standard fee.
Specialist Services: If referred for additional procedures such as X-rays or laboratory services, the relevant specialist will generate the applicable account separately.
Emergency care often involves multiple providers and resources, which can make billing seem complex. We are committed to helping patients understand each component of their bill.
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