Urgent Care Facility or Freestanding Emergency Room?

Recent legislature has addressed the financial confusion; Rapid Med addresses which facility to choose.

Sometimes surprises are good. Fun. Welcome. And sometimes they’re none of those things, as is the case when a patient receives a bill that’s almost ten times what they had anticipated because they mistakenly went to a freestanding emergency room (ER) instead of an urgent care facility. Their insurance company has treated the event accordingly, just as if the patient had been seen in a full-scale hospital ER. It is, or least it was, an easy mistake for the patient (or responsible party) to make up until the beginning of this year.

Effective September 1, 2015, with a compliance deadline of January 2, 2016, SB 425 requires most freestanding ERs to clearly and prominently post the following information throughout the facility and on their website:

  • The facility is an emergency room and charges fees comparable to a hospital emergency department.
  • The facility may charge a separate facility fee.
  • The facility and/or attending physician may not be a participating provider or in-network for the patient’s health plan.
  • The attending physician may bill separately from the facility.

As stated by Jamie Dudensing, CEO of Texas Association of Health Plans, “. . . SB 425 will give Texans a better idea of what to expect when they visit freestanding emergency rooms, which may look and feel like urgent care centers, but charge the same as traditional emergency rooms. When consumers are empowered with information, they are better able to care for themselves and their families without breaking their bank accounts.”

  It’s also important to note as of this writing that independently owned freestanding emergency centers are not recognized as emergency facilities by the Centers for Medicare & Medicaid Services.  Therefore some of the services performed at these facilities are not covered by Medicare and Medicaid.

green_left_curvlygreen_right_curvlyAccording to the Medicare Payment Advisory Commission (MedPAC),

90% of the independent freestanding emergency centers are located in Texas.

The number has gone from 0 in 2010 to 156 in 2015.

When to go to an emergency room and when to go to an urgent care facility

Thanks to this Senate bill, the financial details of a freestanding ER visit may be clearer to patients upon entering the facility, not after getting the bills. But how does one determine if their medical issue requires treatment in an ER (hospital-based or freestanding) or at an urgent care facility?

First and foremost, if you need care for life, limb or vision threatening emergencies, visit your nearest ER immediately.

If the medical issue doesn’t warrant calling 911, the following are examples of conditions that should be treated in a hospital-based or freestanding ER:

  • Minor-to-moderate chest pain
  • Post-seizure or loss of consciousness
  • Severe abdominal pain
  • Sudden paralysis or slurred speech
  • Uncontrolled bleeding
  • Psychiatric illnesses
  • Snake bite
  • Shock
  • Ingestion of poison
  • Severe burns

The following are examples of medical conditions that urgent care facilities such as Rapid Med–Double Oak and Rapid Med–The Colony can appropriately address:

  • Strep throat
  • Flu
  • Sinus infections
  • Fever
  • Allergies and rashes
  • Skin infections and abscesses
  • Simple gynecologic problems
  • Bronchitis/pneumonia
  • Headaches and migraines
  • Nausea and vomiting
  • Evaluation of acute abdominal pain
  • Cuts of all sizes, sprains and strains
  • Fractures
  • Eye injuries

Urgent care facilities are a bridge between a primary care physician and an ER, offering all of the medical services available through a primary care physician and many of the services available at an ER but at a fraction of the cost. With extended hours, the ability to be seen without an appointment, and most notably, expanded services to treat minor emergencies that don’t require an ER, urgent care facilities serve an important need in every community.

The Rapid Med Advantage

Drs. John and Rebecca Gomez combined their expertise when, in 2006, they opened Rapid Med Urgent Care in Highland Village, TX, offering patients in the community both primary care and urgent care in one location – Dr. John Gomez is Board Certified in Emergency Medicine and Dr. Rebecca Gomez is Board Certified in Family Medicine. “Our extended hours make us more convenient than standard private practices, and we provide greater value than the hospital emergency room. We are dedicated to providing you with quality care quickly,” say the doctors.

Open seven days a week, Rapid Med–Double Oak and Rapid Med–The Colony have recently added a third level of service known as House Calls. This service provides patients with treatment similar to that administered in the office but in the comfort and convenience of their own home. From the Rapid Med website or the House Calls mobile app, patients can view a list of medical issues that qualify for a house call and complete a quick sign-in, then rest while waiting for the healthcare practitioner to arrive.

The bottom line . . .

When you have a medical issue arise, something that cannot wait until the next day but isn’t life-threatening, check to see if your primary care physician can see you. If not, check the hours for a convenient urgent care facility and head there. If you need medical attention after hours, then it’s appropriate to go to an emergency room.

You may not be able to control when you need medical attention, but as far as getting treatment, you have options!

Dr. Gomez
Dr. John Gomez was born in Venezuela but spent most of his childhood in Texas, his father a Spaniard and mother American. After working a few years as a full time emergency physician in a few hospitals, Dr. Gomez noted and came to dislike the inefficiencies and near total lack of personalization required to practice the best medicine. He developed a perspective that medical care, even when an emergency, should be patient centered and streamlined and it was with this vision that he began Rapid-Med. Dr. Gomez maintains a special interest in ultrasound and sports medicine with emphasis on concussion management. He currently serves on the L.I.S.D. Concussion Oversight Team (COT) as physician advisor and enjoys his close relationship with the local athletic trainers and Flower Mound High School.
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