Hospitals charge nonemergency patients upfront fees

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Starting at 9 a.m. on Monday, patients that came through Newton Medical Center's emergency department and were not truly emergent were charged a fee. When the hand struck 9 o'clock, uninsured patients considered nonemergency cases were charged $150, and insured patients continued to pay a copay or deductible, Rockdale Citizen reported.

The Covington, Ga., facility is one of many hospitals in the country looking to keep the ED limited to real emergency cases and to prevent uninsured patients from treating the ED like a primary care provider.

Hospital leaders at Newton Medical said it had been considering the approach for some time, according to hospital spokesperson Linda Komich.  Twelve and a half percent of its ED visits were not truly emergency cases, Cov News reported.

"This is not about money. This is about the emergency department and treating people with emergencies. We want to provide the best care possible and, doing so, we have to make sure that we are available and (have) the time to spend with people with emergencies," she said, WSB-TV Action News 2 reported.

Hospital officials said the new policy still complies with EMTALA (Emergency Medical Treatment and Labor Act) and will offer truly emergent patients a medical exam and treatment. However, patients the hospital deems nonemergent will be charged with a $150 deposit through cash, credit or debit card for rendered services.

Komich noted that "all other hospitals in the area do this in some form or fashion," Rockdale Citizen reported. Rockdale Medical Center also charges a $150 deposit for non-patients, and Clearview Regional Medical Center (formerly Walton Regional) charges around a $180 deposit, Cov News noted.

According to the Healthcare Financial Management Association, half of the nation's hospitals now charge upfront fees for ER visits. Among them is HCA, one of the largest hospital chains in the country, which in 2011 charged 80,000 patients who didn't need ER treatment a $150 upfront payment each.

Such hospital policies have raised eyebrows among patient advocates who see an increasingly blurred line between hospital and collection agency. Earlier this year, accusations of aggressive collection practices landed Fairview Health Services, a nine-hospital system in Minnesota, and its then-partner Accretive Health in hot water with the state Attorney General and the Centers for Medicare & Medicaid Services. The Minnesota Attorney General in April filed a lawsuit against Chicago-based Accretive, saying it had violated state and federal laws regulating debt collection and patient privacy. The collection firm in July settled for $2.5 million.

For more information:
- here's the Rockdale Citizen article
- read the Cov News article
- watch the WSB-TV report

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