The value of Urgent Care centers

[disneysteve]

This may be a tiny bit self-serving given what I do for a living, but if you are looking to minimize your healthcare spending, Urgent Care (UC) can be a great option. On many insurance plans, the copay to visit the ER is steep. I've seen ER copays as high as $300. Alternatively, UC copays are often the same as your specialist copay, so maybe $40 or $50. On some plans, UC is even the same cost as your PCP.

If you have a problem that needs prompt attention and your PCP either can't see you in a timely manner or doesn't handle those types of issues, UC can save you a bunch of money vs. the ER.

What sorts of things can an UC do? Routine illnesses like sore throats, ear infections, flu, bronchitis, pneumonia, etc. Minor injuries like sprains and most fractures. Laceration repair with stitches, staples, or skin adhesive. Drainage of abscesses. Removal of foreign bodies. Clearing out blocked ear wax. And more.

One thing to keep in mind is that not all UC centers provide the exact same services so it's a good idea to call your local center before heading over to make sure they handle what you would be going for. If you have various centers to choose from (my area is swamped with UC locations from at least 8 different companies that I can think of), take a look at the websites of the ones closest to you to see if there are any significant differences and also to check the hours which also vary from company to company.

Not only is there a financial savings from going to UC instead of the ER, but because of the extended hours, you may save by not having to leave work early or take off entirely in order to get treatment.

[creditcardfree]

You make a good point to check out surrounding Urgent Care Centers to determine services ahead of time. This is good information to know before one needs the services.

[naomi_w]

thanks for the info on urgent care! points taken

[Smallsteps]

did anyone see the article about some insurance companies now sending letters stating they will be and some already starting to deny ER claims if they deem it non emergency and should have be treated at an urgent care or private practice??

[msomnipotent]

did anyone see the article about some insurance companies now sending letters stating they will be and some already starting to deny ER claims if they deem it non emergency and should have be treated at an urgent care or private practice??

Everything old is new again. I remember dealing with a few cases when I worked in hospital billing long ago where the insurance wouldn't pay because it was a nonemergency. Normally, I would side with the insurance. I had to do paperwork for people with the sniffles when I worked in ER admitting, and I thought it was outrageous. My sister had to take her daughter to the ER this week for a raging tooth infection (the dentist told them to go get an IV right NOW) and she had to wait with people who had colds. We live in an area that has an overabundance of doctors, urgent care, and those quick care centers. There is no excuse.

But then again, some people were getting denied when they thought they broke their arm and it wasn't. And I had to fight my insurance in my 20's because the ER doctor stupidly misdiagnosed me with a UTI when I had a raging case of Fifth disease and had to miss a month of work. I worry about those types of problems popping up again. And I pray that they don't allow pre-existing conditions to be denied again. I couldn't get health insurance when we lost ours because I have RA.

[disneysteve]

did anyone see the article about some insurance companies now sending letters stating they will be and some already starting to deny ER claims if they deem it non emergency and should have be treated at an urgent care or private practice??

Everything old is new again.

I was thinking the same thing msomnipotent. In the early days of HMOs they tried that nonsense. If you went to the ER, they would decide after the fact if they were going to cover the visit based on what was found. So if you fell and hurt yourself and went in for an x-ray, if you had a broken bone that was considered an emergency and was covered but if the x-ray was normal it wasn't an emergency and they wouldn't cover it. It was insane. How is anyone supposed to know if their bone is broken without getting the x-ray. Thankfully, they eliminated ludicrous policies like that.

The problem, at least around here, is that urgent care centers are a relatively new thing. It's really only been in the past 5 years that they've popped up so most people still aren't familiar with them and what services they offer. A lot more education of the public is needed before companies should start denying ER visits that could have been treated at an urgent care center.

I also encountered an issue just yesterday that needs attention. Our insurance, which is through my job at the urgent care center, includes a Teladoc service where you can be treated by phone for minor stuff. They sent out a list telling when you should use Teladoc, when you should go to urgent care, when you need the ER, and when you need to see your PCP. However, everything they listed for Teladoc is stuff we see on a daily basis at urgent care, and a few things they listed for the ER are also things we handle at urgent care. If all patients actually followed that advice, our urgent cares would probably go out of business because Teladoc and the ER would siphon off most of our patients. So even the insurance companies themselves aren't getting it right.

[kork13]

I personally dread any visit to the ER (a visit to ANY doctor, perhaps? No offense, Steve! ) ... And perhaps I've been trained too well by my insurance company... But I really see an ER as a treatment center for "life, limb, or eyesight", or as an option of last resort (like, it's 2am and literally nothing else is open). I'm really grateful for the proliferation of Urgent Care centers across the country. They tend to be less busy/crowded, far less costly, and open at most hours of the day/night. Within 1 mile of my house, I've got 5 UCC's, with hours ranging between 6am - 8pm, 7 days a week...and many more options just a few miles away. So for pretty much anything that comes up, if our primary doctor isn't open/available, a UCC is my top option. I've only been to them for ear infections, strep throat, sprains, stitches, and minor stuff like that. Things that you need to see a doctor to deal with, but can't wait 2-5 days to get an appointment with your normal doc.

One thing that I really like about our insurance is that they have a call-in line where you can talk to a triage nurse. You discuss what's going on, and they tell you whether to go to the ER, a UCC, or just to see the primary doc within the next few days. Only twice have they told me to go to the ER -- when DW had a threatened miscarriage (random bleeding but the child turned out to be just fine), and when our then-9mo-old was projectile-vomiting everything he was fed (and then some) for about 24-36 hrs. For basically everything else (I'm one to only call if I'm legitimately worried something could be truly wrong), it was "Go to the nearest UCC, I'm putting in a referral for you (which reduces our copay, sometimes to $0). Do you know where one is? Let me connect you to someone who can find one that's open right now." I know most people wouldn't dream of saying this, but for that one feature, the 24/7 nurse's help line, I love my health insurance. We don't get acutely sick very often, but when we do, it's REALLY nice to get some legitimate advice on what we should do, even in the evening/middle of the night (which most of my calls to them have been).

[Thrif-t]

I was pretty excited to get this email from my regular doc, unlike all of you we don't have a bunch of Urgent Care's in our neighborhood, they're 20-30 min away:

Physicians Network is excited to announce an after-hours clinic offering full office services for acute care. (i.e., sore throat, respiratory infections, urinary tract infections, acute musculoskeletal issues, etc.)

All established patients are welcome to use the After Hours Clinic. Visits will be billed as a usual office visit, not as an urgent care visit so there will likely be a co-pay savings.

Starting November 3rd, you may request an appointment via the app, your patient portal, or by calling your physician's office outside of working hours to be connected to our call center.