To date we have seen over 1,400 patients in our urgent care. Our clinical and patient experience feedback has been great, but we have gotten some questions and concerns over the billing. The urgent care center is located within the hospital space and shares with our wound care center. As such, the billing place of service is the hospital, which changes how some insurance companies treat it. We have done an analysis for all of our billings. Our average patient out of pocket expense is $54 for urgent care. This includes all charges from the clinic, to lab, to radiology etc. Broken down by insurance, Blue Cross average is $62, Medicare is $16, Medicaid is $11 and all other commercial payors is $85. The single biggest reason for the commercials having a higher average is that they have not met their deducible yet. Once their deducible is met, the out of pocket expense for our urgent care service will decline tremendously and often be under $20 or in many cases $0.
Urgent care should never replace your primary care provider. It is always best from a continuity of care and financial standpoint to seek care from your primary care provider, however, we wanted to ensure that we had that access for times where that was not possible. We also wanted that access to be much less expense than and emergency department visit which this is. We understand that even with the convenience of location and shorter wait times, some patients may choose a less expensive out of pocket option for their care, however, we want to ensure we provide the right education. The key for commercial insurance is understanding your deducible. If you have met it or are very likely to meet it, then the billing model won’t make a difference or may even be cheaper.
If you have questions regarding urgent care billing, please feel free to call 319-332-0999 and ask for the business office.