Freestanding urgent care clinics have popped up all over America. Whether it’s free standing, in a strip mall or a clinic within a pharmacy, urgent care centers have become an almost ubiquitous way for people to receive care.
According to a Becker’s Hospital Review article and the Urgent Care Association of America, there are 9,000 urgent care clinics in the U.S. and 40 percent expect to expand their existing site or open new locations.
Often, the primary medical reasons that people go to these clinics are:
- Upper respiratory tract infection (e.g., cold, flu, cough from an acute infection, nasal congestion)
- Urinary tract infection (often referred to as a UTI)
- Joint and muscle sprains and strains (e.g., twisted ankle)
Often, the primary personal reason that people go to urgent care clinics is:
- Convenient location
- Convenient appointment availability
Especially around the holidays when people are traveling and not near their regular doctor or because the regular doctor’s office is closed, urgent care clinics become a frequently used option.
Here are four mistakes to avoid when going to an urgent care clinic:
- Know how your insurance covers urgent care visits before you go. If you have a PPO plan, the copay may be more than a regular office visit copay (e.g., $75 urgent care copay vs. $50 specialist copay vs. $25 primary care copay). However, usually, urgent care co-pays are less than emergency room visit co-pays (which are often $100 or more).
- Some urgent care clinics are hospital emergency rooms in disguise. If a clinic is associated with a hospital (and sometimes even if it is not), it will consider itself an ER and bill like an ER. You need to ask the urgent care clinic in advance if it bills as urgent care or as an ER and get the name of the person who tells you. Just because they say that it will be billed as urgent care doesn’t mean that it will. If 30 days later you receive a bill for an ER visit, you can go back to the billing office of the urgent care center armed with the employee’s name who told you differently.
- Need a prescription? There may be another way to get it. If you have an established relationship with a doctor (e.g., family practice physician, pediatrician, internist, Ob/Gyn), you may be able to call that doctor’s office or their after-hours line to tell them your symptoms and often they can call you in a prescription. They may want you to come in for a follow-up visit in one or two weeks, but at least you can get your prescription rapidly. Primary care physicians and Ob/Gyns may do this for upper respiratory tract and UTI symptoms in established patients.
- Forgotten or have run out of a medication? If you have refills still left at your home pharmacy, you often can have your home pharmacy transfer a refill to a pharmacy at your travel location (e.g., near Grandma’s house). You do this by going to a pharmacy at your travel location, telling them you have refills at your home pharmacy and giving them the name and number of your home pharmacy. They may call the home pharmacy for your or they may ask you to call your home pharmacy, but either way, you can avoid having to go to an urgent care clinic to get a new prescription by just transferring an existing prescription.
Being a smart healthcare consumer can be challenging—but doing it well can result in you receiving excellent care and saving hundreds of dollars.
One way to be more informed is to use. Alight's Compass healthcare navigation services to help maximize your health insurance and improve outcomes. If your employer is considering new benefits for your workforce, and wants to save on health plan costs for your organization, tell them more about Compass Healthcare.