Practice Management Alert

Question: A patient comes to our office, presenting with inner ear pain and dizziness. He cannot pay his copay. Do we have to see this patient under EMTALA?

Washington Subscriber

Answer: If a patient cannot pay, you do not have to render services. Since this is not an emergent situation, your best bet may be to suggest the patient reschedule for another time when he can bring his copayment with him.

Private physician practices do not fall under the Emergency Medical Treatment and Active Labor Act (EMTALA) regulations that affect emergency rooms. EMTALA dictates that participating hospitals -- in other words, hospitals which have entered into provider agreements under which they will accept Medicare payment for services provided to beneficiaries of that program -- must provide -an appropriate medical screening examination- to a patient who -comes to the emergency department- seeking -examination or treatment for a medical condition- to determine if he patient is suffering from an -emergency medical condition.- If he is, then the hospital must either pro-vide him with treatment until he is stable or to transfer him to another hospital in conformance with the statute's directives.

Bottom line: Inner ear pain and dizziness are not likely indicative of an emergency situation, which means EMTALA would not apply. Plus, as a private practice you are not held to the EMTALA rules like an emergency room would be. Therefore, you can choose what is the best way for your practice to handle this situation.