Wednesday, April 20, 2016

Urgent Care versus ER

This was on my Facebook timeline today, and I wanted to keep it for our use, as well as let friends, especially those RVing around the country, know.

http://www.fox4news.com/news/consumer/127248978-story

I'm including some quotes:
...do you really know the difference between an urgent care facility and a freestanding emergency room?
First, emergency room is not just a clever marketing name for an urgent care clinic. If you see ER, understand that you’re walking into one even if it’s not attached to a hospital. They have equipment like ERs, board certified physicians like ERs and they can admit you to a hospital like an ER.
Texas law requires these medical centers to use the words emergency room in their name so consumers understand what they’re getting into.
Still, as many as 65 percent of people are choosing wrong. That’s how many cases are being treated at freestanding ERs that are not life-threatening.
Freestanding ERs charge a facility free and professional office visit fee, which can be 80 percent of the massive difference in the bill. Labs and medicines at ERs also generally cost more.
It’s okay to ask at the front counter. Will this be a $20 or $30 co-pay or will this be $100 co-pay for an ER visit?
Freestanding ERs or ER departments can charge urgent care rates if it’s determined that a patient didn’t need the ER, but that almost never happens.
There’s also a lot of variety when it comes to walk-in urgent care facilities. In general, these are walk-in clinics that focus on treating non-life-threatening illnesses that require immediate attention but are not serious enough for an ER.
Most, but not all, are staffed by a physician, physician assistants, advanced practice clinicians and nurse practitioners. These clinics are not required to have a licensed physician on staff. And their normal office co-pays are designated by the insurance provider at a non-ER rate.
There are also some new hybrid centers like Legacy ER and Urgent Care. They are supposed to completely remove the guess work from the equation because patients can show up to one place and the doctors will direction their care as urgent or emergency based on their evaluation.
It may seem like doctors would always direct people to the ER so they could make more money, but the folks at Legacy claim more than 80 percent of patients who walk in the door are treated as urgent care patients.
Last, there are some important details to remember about Medicare and Medicaid. In general, Medicare doesn’t recognize these freestanding ERs and will not reimburse them for ER services. The exception is a freestanding ER which is a satellite of a hospital.
Note: the guy who posted this to the Coppell FB timeline is medical director at Legacy ER and Urgent Care in Coppell.

I have been hesitant to use any of the "urgent care" facilities because I have heard horror stories about care not being covered; based on this, I will feel more confident about using the "urgent care" places (especially when we're traveling) and know to ask at the entry for more details about what the charges will be. I don't know whether we can count on the "labeling" to include "ER" in the name outside of Texas.

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