Expensive "Urgent Care"?????????

fuzzybuddy

fuzzybuddy

SF VIP
Location
The Sticks, Northeast PA.
I was mowing the lawn, and came in contact with something. I had four dime sized red areas on my wrist. I didn't know if it was infected or what, so I wanted to get it checked. I didn't want wait till September to get a regular appt., so I tried an "Urgent Care" place.. I got an appt for the next day. The doc said it was contact reaction and prescribed a cream. Then I got a bill for $50, as not covered by my insurance. But what floored me was my insurance paid $731 for an "Emergency Room" visit. This was a doctor's office, not a hospital facility. Ambulances weren't bringing patients for treatment to this place. I could see a $200-300 fee as very well paid, but $781. "Urgent care" isn't "Emergency" care.
 

fuzzybuddy said:
I was mowing the lawn, and came in contact with something. I had four dime sized red areas on my wrist. I didn't know if it was infected or what, so I wanted to get it checked. I didn't want wait till September to get a regular appt., so I tried an "Urgent Care" place.. I got an appt for the next day. The doc said it was contact reaction and prescribed a cream. Then I got a bill for $50, as not covered by my insurance. But what floored me was my insurance paid $731 for an "Emergency Room" visit. This was a doctor's office, not a hospital facility. Ambulances weren't bringing patients for treatment to this place. I could see a $200-300 fee as very well paid, but $781. "Urgent care" isn't "Emergency" care.
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Medical experiences that make you feel like you are being marketed are becoming so much more common.
 

That seems to me as being excessive. I have used walk-in clinics that don’t need appointments for a URI and once I had a UTI. Both times, I walked in, didn’t wait very long, got a checkup for my URI and a test for my UTI and they sent scripts to my drugstore and the visit was over. When I got the bill for the URI, it was $219 and Medicare paid $175 and my supplemental paid the balance. I don’t have the other statement for the UTI. My meds for both issues didn’t cost me anything.

You may want to call them and ask the billing department to take another look at your invoice. I hope they made a mistake in your favor. That amount seems out of the ordinary.
 
StarSong said:
It' highly likely that your insurance company paid nowhere near $731 for your visit. Insurance companies have special rates and negotiate bills with ERs, urgent cares, hospitals, doctors, testing centers, etc.
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I can see that and then if you don’t know the final settled bill, the patient thinks how wonderful his insurance company is to have paid so much. Smoke and mirrors.
 
Bonnie said:
But if you think about it, they mean the same thing.
That's probably why they use that name, to get the insurance money.
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technically they don't. urgent means it's important enough to be dealt with now. the emergency is when it's more life threatening. many insurance companies are starting to refuse to pay if it's not an actual emergency.
 
Bonnie said:
But if you think about it, they mean the same thing.
That's probably why they use that name, to get the insurance money.
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Unfortunately, I agree. I think that's what irritates me. The whole thing has a "scam" feeling. Urgent Care vs Emergency Care. A boo boo is not an "EMERGENCY", but it is urgent. If this boo boo was infected, I don't want to wait till September 28th for an appointment. And this was a regular doctor's office, it was no damn ER.
 
This is why transparency in MEDICAL pricing should be in place.... one place in my area tried it menu form and competition and insurance groups went NUTS....
If a urgent care is operating as "emergency" care it is to play games in the coding for Billing.........

They should have a sign or informed as you sign in ...that THIS clinic etc follows ER RATES ....for billing purposes...

perhaps if like when you pick up a repaired auto or at a restaurant................ you sign that A,B and C were in fact done or ordered.....
and no bill for items they simply did not provide.... was once charged for drugs I simply did not get OR take.

MOST people do not go through an itemized bill and have things taken off in medical bill...........................................but if you were charged for drinks or desserts you did not order or have when eating out ... My bet is people would ask to see a manger about being billed for extra items.
 
fuzzybuddy said:
Unfortunately, I agree. I think that's what irritates me. The whole thing has a "scam" feeling. Urgent Care vs Emergency Care. A boo boo is not an "EMERGENCY", but it is urgent. If this boo boo was infected, I don't want to wait till September 28th for an appointment. And this was a regular doctor's office, it was no damn ER.
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If you can't find information on the Internet, I've always found the local Pharmacy helpful in issues of that nature
.... they can give advice without asking for insurance.

And they probably have the recommended products that Urgent Care would give anyway.
 
They billed over $700 because they knew they could get it with that plan. Just like a hospital emergency room. This is why the industry doesn't want full disclosure or single rate/fee pricing.

It is cheaper than an ER which is basically what urgent care said they do. But they could be one dollar under an ER visit and they are cheaper.
 
fuzzybuddy said:
Unfortunately, I agree. I think that's what irritates me. The whole thing has a "scam" feeling. Urgent Care vs Emergency Care. A boo boo is not an "EMERGENCY", but it is urgent. If this boo boo was infected, I don't want to wait till September 28th for an appointment. And this was a regular doctor's office, it was no damn ER.
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Yes, it's a common fraud by internal hospital staff and should be reported immediately to Medicare or the state health department or at least AARP!

I worked for large well known hospital of 5,000 employees. One of the departments there was billing Medicare for inpatient charges rather than outpatient charges...big difference and many hospitals are guilty but get away with it. But this time action was taken and the hospital was made to pay $8 Million! It was actually more but lawyers got it reduced for them.

Then all employees throughout the hospital, including myself were made to take ethics classes and pass multiple ongoing timed tests about procedures in all departments despite the fact that we were totally unaware of that one small department's scam. It didn't matter if our job was not medical, or that we were not involved nor even had knowledge of the scam...ALL 5,000 employees had to take and pass the ethics tests.
It was all over the news.
 
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we will need to learn how to take care of boo boos as the future progresses...there are many plants that are truly miraculous with their properties of healing immediately.
 

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