Thursday, February 7, 2013

Emergency Rooms vs. Urgent Care: Differences in Services and Costs published an article on the differences in services and cost on Emergency Rooms and Urgent Cares. Highlights of the article are located in the bullets below:

Emergency Rooms
  • Have 5 Levels of Care
    • Level 1 is Minor Problems and Level 5: More Severe Problems
  • Required to provide care to all patients
  • $18 billion could be saved if patients with non-urgent medical problems go to a primary or preventive care center.
Emergency Room Costs
  • ER Costs correspond with the severity of the patients illness or injury
  • Physician's Fees are typically about 20-25% of the total charges
  • Costs vary in different parts of the country
  • Average visits in 2009 were $1,318
  • Average in-network visit in 2011 was $933
  • Average visit in 2009 for common illnesses - (middle ear infection, pharyngitis and UTI) was $570 
Urgent Care Centers
  • Free-standing, walk-in medical facilities that provide care with no-appointments.
  • They are open extended hours as well as nights and weekends.
  • Serve those with non-life threatening medical situations.
  • Take in $13 billion dollars in revenue annually.
Urgent Care Center Costs
  • Less significant costs than the Emergency Room
  • Urgent care estimates say that the visit can cost anywhere from $71 to $125
Paying For Emergency Room Visits
  • Private insurance: 54%
  • Medicare: 38%
  • Medicaid: 33%
  • Uninsured Patients: 35%
Paying For Urgent Care Visits
  • Fee-for-service basis
  • Usually accept most private insurance plans
  • Co-pays are around $25-$50 per visit for those who have health insurance
  • Discounts are usually offered for those without insurance.
For the full article, please click the following link: Emergency Rooms vs. Urgent Care: Differences in Services and Costs.

For additional billing and coding resources  please click the following link: Medical Reimbursement Billing and Coding Resources Page.

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