Emergency Rooms vs. Urgent Care: Differences in Services and Costs

Debt.org 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.

Choosing Emergency Room Care vs. Urgent Care Centers

Do you know all the facts when it comes to choosing whether to go to the Emergency Room or an Urgent Care Center?

An article published on fairhealthconsumer.org highlighted important information that you should know.

The article discussed the following:
Emergency Room Care

• You many encounter: ER co-payments, co-insurance or deductibles
• You many encounter: Additional ER out-of-network charges
• Deals with potentially life-threatening emergencies & is open 24 hours a day
• Many plans cover a portion of emergency care
• Most health plans will not pay for ER visits if the visit is not considered an emergency
• To determine this they follow the “Prudent Layperson Standard” under PPACA to determine what is a true emergency.

Urgent Care Centers:

• Most health plans include urgent care centers in their networks
• Have extended hours (primarily when your primary care doctor is not available)
• Provides treatment for less serious emergencies
• Not equipped to deal with major medical traumas or emergencies

The article also went into the cost of the Urgent Care vs. the cost of the Emergency Room.

To view the full article, please go to the following link: Emergency Room Care vs. Urgent Care