OKC Hospital ER Charges Fees for Non-Emergency Service

[guido911]

So much for the ER being a source for primary care, stubbed toes, etc. without a consequence.

http://m.news9.com/story.aspx?story=25496818&catId=112032

[Gaspar]

Not a bad idea.  There has been an explosion in the development of "Urgent Care" clinics across the country.  You can hardly drive 5 miles in Tulsa with out passing at least one.  In South Tulsa, where I live, there are minor clinics popping up everywhere.  67st Yale, 71st Yale, 91st Delaware, 101st Riverside, 91st Memorial, 101st and Sheridan, etc.

Many of these are run by experienced docs, PAs and Nurses who wanted to escape the hospital/insurance company run hell.  Most accept insurance, but do most of their business in cash. It's an extremely profitable business.  A couple of months ago I had an ear infection that really hurt.  I called my doc, and he recommended I go to minor emergency at St. Francis (covered under my insurance).  I called and they had a 3 hour wait.  I went to the urgent clinic at 71st and Yale, and was seen immediately. I had a ruptured ear drum.  I received two prescription scrips and some drops onsite.  I paid $67 for the visit.

Last time I went to St. Francis urgent care for a sinus infection, the bill charged to my insurance was over $400 for an hour wait and 2 minutes with a PA. I'm confident that the PA was paid less than $67 for her time with me.

Many of these urgent care facilities offer a full spectrum of services now, including Xray, EKG, and even in-house pharmacy, and the cost is a fraction of what you would pay at a hospital.  CVS pharmacy is slated to put a minor clinic in all of their pharmacies, so soon we will be able to go to the corner drug store for a broken arm instead of sitting for hours at a hospital. 

[guido911]

Not a bad idea.  There has been an explosion in the development of "Urgent Care" clinics across the country.  You can hardly drive 5 miles in Tulsa with out passing at least one.  In South Tulsa, where I live, there are minor clinics popping up everywhere.  67st Yale, 71st Yale, 91st Delaware, 101st Riverside, 91st Memorial, 101st and Sheridan, etc.

Many of these are run by experienced docs, PAs and Nurses who wanted to escape the hospital/insurance company run hell.  Most accept insurance, but do most of their business in cash. It's an extremely profitable business.  A couple of months ago I had an ear infection that really hurt.  I called my doc, and he recommended I go to minor emergency at St. Francis (covered under my insurance).  I called and they had a 3 hour wait.  I went to the urgent clinic at 71st and Yale, and was seen immediately. I had a ruptured ear drum.  I received two prescription scrips and some drops onsite.  I paid $67 for the visit.

Last time I went to St. Francis urgent care for a sinus infection, the bill charged to my insurance was over $400 for an hour wait and 2 minutes with a PA. I'm confident that the PA was paid less than $67 for her time with me.

Many of these urgent care facilities offer a full spectrum of services now, including Xray, EKG, and even in-house pharmacy, and the cost is a fraction of what you would pay at a hospital.  CVS pharmacy is slated to put a minor clinic in all of their pharmacies, so soon we will be able to go to the corner drug store for a broken arm instead of sitting for hours at a hospital.  

I was treated for bilateral pneumonia and dehydration in an urgent care one evening. Made it to work the next day.

[Cats Cats Cats]

Not a bad idea.  There has been an explosion in the development of "Urgent Care" clinics across the country.  You can hardly drive 5 miles in Tulsa with out passing at least one.  In South Tulsa, where I live, there are minor clinics popping up everywhere.  67st Yale, 71st Yale, 91st Delaware, 101st Riverside, 91st Memorial, 101st and Sheridan, etc.

Many of these are run by experienced docs, PAs and Nurses who wanted to escape the hospital/insurance company run hell.  Most accept insurance, but do most of their business in cash. It's an extremely profitable business.  A couple of months ago I had an ear infection that really hurt.  I called my doc, and he recommended I go to minor emergency at St. Francis (covered under my insurance).  I called and they had a 3 hour wait.  I went to the urgent clinic at 71st and Yale, and was seen immediately. I had a ruptured ear drum.  I received two prescription scrips and some drops onsite.  I paid $67 for the visit.

Last time I went to St. Francis urgent care for a sinus infection, the bill charged to my insurance was over $400 for an hour wait and 2 minutes with a PA. I'm confident that the PA was paid less than $67 for her time with me.

Many of these urgent care facilities offer a full spectrum of services now, including Xray, EKG, and even in-house pharmacy, and the cost is a fraction of what you would pay at a hospital.  CVS pharmacy is slated to put a minor clinic in all of their pharmacies, so soon we will be able to go to the corner drug store for a broken arm instead of sitting for hours at a hospital. 

So the urgent care charges less than my primary care physician but my insurance insists on charging me more for the Urgent Care visits

[Gaspar]

So the urgent care charges less than my primary care physician but my insurance insists on charging me more for the Urgent Care visits

It's great news if you have the most "affordable" plan on Obamacare, your bronze plan under Obamacare in most cases carries an insanely large yearly deductible, on top of the amount you'll pay a month unless you are poor, then you pay less (except for a portion of your "affordable" deductible), so if you're a young single professional on a plan through the exchange, you will want to find the cheapest care available, since it's coming out of your pocket anyway. Oh, and even if you exceed your insane deductible for the year, you still get to pay 40% of whatever else you owe on a bronze plan.  It seems that if you liked your crappy insurance, you now get to buy crappier insurance that doesn't really cover crap (excepting of course your Fluke-control and "howdy" doctor visits). 

$67 sure beats going to your doctor for a $500 out of pocket hit! 

Funny how this is evolving.  I'm happy about the growth of this industry.  Anything that doctors can do to get out from under the umbrella of the institutionalized medicine and big-insurance is good. 

[RecycleMichael]

My doctor is really cheap. Unfortunately, he mixes the medicine he gives me in a cocktail shaker.

[Conan71]

Not a bad idea.  There has been an explosion in the development of "Urgent Care" clinics across the country.  You can hardly drive 5 miles in Tulsa with out passing at least one.  In South Tulsa, where I live, there are minor clinics popping up everywhere.  67st Yale, 71st Yale, 91st Delaware, 101st Riverside, 91st Memorial, 101st and Sheridan, etc.

Many of these are run by experienced docs, PAs and Nurses who wanted to escape the hospital/insurance company run hell.  Most accept insurance, but do most of their business in cash. It's an extremely profitable business.  A couple of months ago I had an ear infection that really hurt.  I called my doc, and he recommended I go to minor emergency at St. Francis (covered under my insurance).  I called and they had a 3 hour wait.  I went to the urgent clinic at 71st and Yale, and was seen immediately. I had a ruptured ear drum.  I received two prescription scrips and some drops onsite.  I paid $67 for the visit.

Last time I went to St. Francis urgent care for a sinus infection, the bill charged to my insurance was over $400 for an hour wait and 2 minutes with a PA. I'm confident that the PA was paid less than $67 for her time with me.

Many of these urgent care facilities offer a full spectrum of services now, including Xray, EKG, and even in-house pharmacy, and the cost is a fraction of what you would pay at a hospital.  CVS pharmacy is slated to put a minor clinic in all of their pharmacies, so soon we will be able to go to the corner drug store for a broken arm instead of sitting for hours at a hospital. 

Great clinic there at 71st.  I had to get a few stitches there last mother's day after I tried to rearrange my face and rib cage on my mountain bike at Turkey Mountain.  Very quick and professional.  $75 and still made it to Mother's Day dinner out of town on time.  Would have taken many more hours at the ER or a hospital-affiliated MEC.

[sgrizzle]

The people who pay for their medical care are not the ones treating the ER as their primary care provider.

[patric]

Would have taken many more hours at the ER or a hospital-affiliated MEC.

Are non-hospital-affiliated clinics referred to as something different than an MEC?
Just wondering if I had to look one up, if they distinguish.

[sgrizzle]

Great clinic there at 71st.  I had to get a few stitches there last mother's day after I tried to rearrange my face and rib cage on my mountain bike at Turkey Mountain.  Very quick and professional.  $75 and still made it to Mother's Day dinner out of town on time.  Would have taken many more hours at the ER or a hospital-affiliated MEC.

Have to second the 71st and yale guy. Almost every family member has ended up there once upon a time. Even one family member who was complaining of leg pain and the Doc there diagnosed it as a DVT and got them into a hospital room faster than the ER would have at 1/10th the price and hassle.

[sgrizzle]

Are non-hospital-affiliated clinics referred to as something different than an MEC?
Just wondering if I had to look one up, if they distinguish.

There are clinics, which substitute for Primary care docs.

Minor emergency centers are for sick visits only.

Urgent care are for sick visits and slightly higher levels of trauma. They also have direct hospital admit privileges, even if not directly tied to a hospital.

The name on the building has little relation to actual classification.

[Gaspar]

Most of these clinics are doctor owned.  I know of one group of St.Francis ER docs that opened the Med Centers several years ago and now they franchise the operations through Nextcare to docs interested in purchasing the concept instead of going to work for one of the big machines. The level of freedom they have in treating and diagnosing patients is wonderful, and because there is less paperflow they can admit a patient much faster than the ER connected to the hospital.  Basically it's like an admit from your doctor's office.

Admits from the ER are treated more like transfers because the hospital considers the patient "under care" even if they are sitting in the ER waiting room for 8 hours waiting for a room (you have had your vitals taken, and your level of liability to the hospital is recorded).  If you are an outside admit, the moment you reach the admitting desk, you become a liability because you have not been assessed internally.  The hospital has a legal priority to get you into a room and have a nurse fully assess you.

Strange as it seems, going to a doc's office or minor/urgent care with an admittable condition will get you into the "comfort" of a hospital room far faster than going to the ER.

We used to (unofficially) hint to stable patients that would show up at triage with an admittable condition that they would have a much better experience if they would just go into the waiting room and call their doc and ask to be admitted.  The good docs would do this (single phone call from the doc and about 10 minutes to provide standing orders), the lazy ones would call us and order "EP Check and Treat" (because I'm busy and don't want to deal with it until morning) at which point the patient would probably spend the whole night just sitting in a bed in the ER listening to the screams of children and real emergencies bursting through the back door.   Ahh, the memories.  At around 8am the private doc would show up with mock concern on his/her face, and say "we're trying very hard to get you into a room."  He/she would write up some orders and then leave.

[sgrizzle]

Admits from the ER are treated more like transfers because the hospital considers the patient "under care" even if they are sitting in the ER waiting room for 8 hours waiting for a room (you have had your vitals taken, and your level of liability to the hospital is recorded).  If you are an outside admit, the moment you reach the admitting desk, you become a liability because you have not been assessed internally.  The hospital has a legal priority to get you into a room and have a nurse fully assess you.

True certified urgent cares can bypass the admission desk.