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Urgent Care VS. ER, Do Your Homework

Urgent Care VS. ER, Do Your Homework

Sticker shock at neighborhood urgent care facilities as some patients find their insurance companies won't cover some of the costs.

Some report bills up to $3,000 for treatment of an asthma attack.  Its a combination of prices going up at walk-in clinics and insurers questioning those costs.  Aetna has even sued three urgent care clinics over fees.

“The state is most concerned with licensure, basically that's a health and safety check,” says John Hawkins at the Texas Hospital Association.  “The payment side is really a market negotiation.”

Patients have to do their part too.

“They need to do some legwork with their insurance carrier to see what is covered, what isn't and what their out-of-pocket cost is going to be,” Hawkins tells KTRH News.

 

Keep in mind, many freestanding ERs don't accept Medicaid or Medicare at all.

 

“Patients really need to see what they're out-of-pocket is going to be in those facilities and what they're getting for that,” says Hawkins.  “Its going to be higher cost if it is 24-hour coverage or if there is backup specialty coverage."

 

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