This post is a bit out of the norm for me but I thought a good number of my Texas readers would be interested in this information.  Have you noticed the large number of stand alone emergency care centers popping up?  They look a lot like a CareNow or a Minute Clinic but they are vastly different!

My mother-in-law recently popped into an emergency care clinic near her home when she became ill.  The facility was built in an old Eckerd Pharmacy store that had been remodeled.  About five years ago, legislation went through Austin allowing stand alone emergency clinics.  The major difference between these care centers and an urgent care facility is the price.

How many of us would knowingly go to the emergency room if we think we have strep throat?  Very few of us.  But when you step into an emergency care clinic, which might look just like a CareNow, you have indeed stepped into an emergency room.  It is a mistake that countless Texans have made since this legislation was passed.  The bill for the strep throat test at the emergency care clinic was $400 plus service fees.  For comparison, Minute Clinic lists the price for a strep test on their website at $30.

Emergency care clinics charge emergency room prices for services and pass the added expense along to the insurance companies and the consumer.  In many cases the insurance company will go ahead and pay the bill, which is one reason our premiums are so high.  But in some cases insurance companies reject charges from these facilities leaving the consumer on the hook for the inflated pricing.

Dave Lieber, an investigative reporter for the Dallas Morning News, wrote an in-depth article about these facilities and the legislation that allows them to operate.  (You can read the FEC Licensing Act here.)  Mr. Lieber does a great job of pointing out the key way to determine if you are at an urgent care facility or an emergency clinic.  By law, an emergency clinic must have the word “emergency” or “ER” in the title of the business or the numbers “24/7.”

There is nothing wrong with the stand alone emergency clinics.  They offer a vital service if a patient has a true emergency.  They have top-notch equipment and properly trained medical staff.  I felt it was worth writing this post to warn my fellow Texans about these facilities if you think they are just another urgent care facility.  No where in the legislation for these facilities are they required to tell patients the cost for services or if your health insurance will cover the procedures.  It is a buyer beware scenario.

Most of us are not capable of making clear and informed decisions when we are sick or dealing with a medical emergency.  As Mr. Lieber suggested, take a few moments to contact your insurance company to determine if your local emergency clinic is in-network.  When an emergency arises you can make an informed decision about where to seek treatment.  If you are sick, try to visit your primary physician or an urgent care facility like CareNow or Minute Clinic.

Don’t live in Texas?  Similar legislation is passing in states across the country as medical providers look for additional sources of revenue.  Consider doing a Google search for “emergency care clinic licensing” and the name of your state.  If you have noticed a boom of stand alone medical facilities your state has probably enacted similar legislation.