Are ECEP's physicians Board
Certified?
All of our physicians are
board certified in their specialty.
What is the North Carolina
Prudent Layperson Legislation and how does it affect me?
North Carolina General
Statutes § 58-3-176, 58-67-50(c), and 58-3-190 (1997)
require that coverage for emergency services must be
provided to the extent necessary to screen and stabilize
the person covered under the insurance plan. If the emergency
services are obtained from a hospital or other provider
outside the insurance plan's network, the person must
still be covered if a prudent layperson would have
believed that a delay in seeking treatment would have
worsened the emergency or if the person went outside
the plan network for emergency treatment for reasons
beyond the covered person's control.
This
legislation also bans
prior approval of emergency treatment if a prudent
layperson, acting reasonably, would have believed an
emergency existed. If prior approval has been given by
the insurance plan for emergency treatment, that
approval cannot be retracted after the services have
been rendered unless the provider or the patient
materially misrepresented the patient's condition. The
North Carolina Prudent Layperson Legislation also requires that an
insurance plan impose deductibles and copayments on
emergency treatment equal to other treatment.
Additionally, the North Carolina Prudent Layperson
Legislation requires that insurance plans provide
information to their enrollees about coverage of emergency medical
services, the use of emergency medical services, cost-sharing
provisions for emergency medical services, and
accessibility and availability of emergency medical services.
What this means to you as a person
covered under an insurance plan is that if you have
met your annual insurance plan deductible and the amount
the plan pays is less than the total due for the
services provided, leaving you with a balance owed, you do have rights to full payment by
your insurance company for emergency medical care in
North Carolina, whether or not our group or any other
emergency provider is contracted with any insurance
company. If you have not met your annual deductible, you
have the right to receive credit toward your deductible
for the full charges of the medical treatment provided.
If your plan is refusing to allow the full charges for
the emergency services provided, you may want to make
yourself familiar with your rights and further discuss
this with your insurance plan.
Why
did I receive multiple bills for my hospital visit?
You may receive multiple bills
for the same visit to the emergency department, but
these bills are for different services. In addition to
the bill you receive for the professional services
provided by ECEP staff, you will also receive a bill from
the hospital itself, which is for items such as nursing
services, equipment, medication, and supplies provided by
the hospital. You may also receive bills from other
providers, such as radiology and laboratory.
Who do I contact with
questions about my emergency department professional charges?
Questions about your emergency
department charges related to the services provided by
ECEP's providers can be directed to our billing service
provider; Management
Medical Professionals (MMP), at 1-800-868-4872.
If you are insured, your
insurance company will be billed for the provider charges
incurred during your visit if complete insurance
information (insurance company, claims address, policy
number, etc.) was provided at the time of registration.
If insurance information needs to be updated or corrected,
please call the toll free number listed above.
You will be responsible for
payment of your provider charge(s) if you
do not have insurance, if the correct insurance
information is not provided, and for any charges not paid
by your insurance company. You will be notified by mail
of the status of
your emergency room provider charges.
Are the emergency physicians
employees of the hospital?
The hospital has chosen to
contract with ECEP II, P.A. to provide emergency services
to you. This decision demonstrates the hospital’s
commitment to the provision of very good health care.
Do you participate in the
hospital’s Charity Care program?
Many hospitals have
implemented programs to assist
patients who are not able to pay for their hospital
facility charges at the time of service, but these
programs are typically for the hospitals facility charges
only. If you are unable to pay your emergency room
provider charge when you receive the bill, you may contact our billing
service, Medical Management Professionals, at
1-800-868-4872, and they will work with you on setting up a
reasonable payment plan.
I waited several hours before being seen--why did it take
so long?
There are a few things that
cause long waiting times in emergency departments. Many
people who come to the emergency department are very sick
and must be admitted to the hospital. If the hospital has
no beds available, the patient must wait in the emergency
department until a bed becomes available. This can cause
other patients to wait even longer to be seen. Other
people go to the emergency department for minor medical problems that
could be treated by an urgent care center or their primary care physician. Also, the emergency department is a very
busy place that handles many patients who need attention
at the same time. Wait times depend on the number of
patients and their need for medical attention, including
tests and procedures.
Who do I contact if I have
questions about the care I received from the emergency
room provider who treated me?
Questions you have regarding the care you received by the
emergency room provider may be directed to ECEP’s quality
review department at 910-202-3363.