Consumer Watch: Walk-in Clinic Vs. Free Standing ERs

It's the height of flu season and if you've felt it coming on your first reaction may be to go to the nearest clinic in your neighborhood. 
But not all clinics will bill you equally.
Tonight, a consumer alert story to clear up the difference between walk-in clinics and freestanding emergency rooms and it could be a difference of thousands of dollars. 
It's a relatively new industry; allowed by Texas' legislature in 2009, during the 81st legislative session.
After debate and committee hearings, testimony and amendments, a house and senate vote during which all of our local representatives voted "yea" 
Emergency clinics became a viable option for investors in Texas. 
Texas is one of only three states in the United States to have freestanding emergency rooms, like the three here in Amarillo. Colorado, and Rhode Island round out the list. 
You'll see in the name of these clinics, "Emergency" or "E-R,"  and signs are posted many places throughout the building, in waiting rooms, on doors, and next to patient's beds. This is not a typical walk-in clinic; and you will be billed as such. 
A check of the facilities' ratings on Yelp and Facebook tell a similar story. 
Among the many positive reviews, the negatives almost always cite the bill as the reason.
$1,200 for after-hours treatment for a child. 
$1,200 for strep throat. 
And another $1,200 for antibiotic eye drops.
That patient asked to remain anonymous, but gave us permission to use his review. 
He did update his review to explain that ER Now's "patient advocate" had been helpful in sorting out the in-network, out of network confusion. 
But he did end up paying nearly $400 in out of pocket expenses. 
"It isn't right to expect $399 in out-of-pocket expense (with very good health insurance) for a simple prescription, but I can't reasonably fault ER Now for these excesses."
The chairman of ER Now, Dr. Gerad Troutman, tells us the level of care they offer, can be expensive. 
Gerad said "We are both open and available 24/seven all this staff we talked about, everyone is a licensed professional, they're not cheap to be here on a Saturday when you come in with chest pain. Additionally c-t scan, x-ray, lab equipment, all sophisticated equipment all equipment that you may not utilize, but that equipment is always there, waiting and ready for you."
Another issue that can add to freestanding ER's pricing, they can't accept Medicare.
Dr. Troutman tells us with only three states allowing these clinics,  making them qualified providers, just isn't on health officials' radar. 
"We believe that at some point they will recognize free standing emergency centers, just like if you look back 20-years ago there was surgical centers, and we have some of those here in town, when those first started those weren't recognized by Medicare, now they are."
And for some patients there may be recourse. 
The Texas Department of Insurance can help to mediate your bill if the doctor you saw was out of your insurance's network plan. That's what's called a balance bill and if more than $500.
So, to be clear, here are some of the times when you might want to seek emergency care like what one of the freestanding ER's might provide. 
Go to the emergency room if you have a heart attack, or signs of a stroke, a blow to the head or a broken bone. 
But, call your doctor or go to a walk in clinic if you have a puncture wound or a bite, if you have an infection or an abscess, a mild head injury or mild burns. 
Both types of facilities can provide great care.
To choose which place could be best for you, ask yourself is this a true emergency or just a trip to the doctor.
Dr. Troutman assures us that his "ER Now"s want to do everything they can to help their patients work out billing problems. 
They do have a patient advocate, as we mentioned who can work to help sort out billing and work with you to help pay your bill.

More Stories

Don't Miss