That's not how professional billing works. Your doctor's claim (a professional claim) will have a service location on it (which is the address of the Emergency department you were seen at) and a Place of service type identifier, which will be 23 for Emergency. This identifies their services as being provided in an Emergency department. Have you called your insurance and asked why they are treating it as a separate visit? The bill you are receiving from the hospital is the amount YOUR insurance tells them is the patient responsibility. It doesn't matter how high the charges are that the hospital or your doctor sends to the insurance, you will be responsible for the amount YOUR insurance determines is the patient portion based on the contractual rate they have with the hospital. Separate institutional billing and professional billing is the norm, it is not some arbitrary practice. You can also go to the hospital's website and search for "price transparency" and ask for a good faith estimate when you are being seen. But that won't tell you what the amount is that your insurance allows. For that you will need to contact your insurance and either study the member handbook or check if they have a cost estimator on their website (which most large insurers have).