urgent care

5 Urgent Care Myths Debunked

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Have you noticed? Delivery of health care services is changing! When trying get the health care you deserve, when you need it, and at affordable cost, you might be confused by all the options, including urgent care. Myths about urgent care have gone viral, preventing many folks from choosing the best alternative. As you decide what’s best for you and your family, don’t be hoodwinked by these common misunderstandings.

Myth #1. Urgent Care and Emergency Room Care Are the Same

While it is true that urgent care centers and hospital emergency departments both treat acute or urgent injuries and illnesses, persons who suffer from a truly life-threatening condition should go to an emergency room or call 911.

Urgent care centers treat most non-life-threatening injuries and illnesses, including broken bones, sprains, cuts, strep throat, bronchitis, allergic reactions, eye and ear infections, low back pain, headaches, nausea, and many more. Waiting times are nearly always shorter and cost is lower than with ERs.

The following chart of symptoms can help you decide where to get the most appropriate care.

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Myth #2. Urgent Care Staff Are Less Qualified

Be assured that all clinical staff at urgent care centers receive the same training as clinical staff in hospitals and family practices. A supervising physician is always present or on call. Other providers such as physician assistants (PAs), advanced practice registered nurses (APRNs), and medical assistants (MAs) must be credentialed and licensed according to state law.

Some urgent care centers also provide specialized clinical services such as orthopedic or pediatric care. When necessary, urgent care centers will refer patients to an appropriate specialist and will often arrange an appointment for a patient more quickly.

Myth #3. Urgent Care Costs More

In nearly all cases, treatment at an urgent care center costs less than at other locations. Because emergency departments must cover high overhead costs for sophisticated equipment and 24-hour staff, charges for ER treatment can be very high. This can be a problem especially if your health insurance plan carries a high deductible amount.

Urgent care centers accept most insurance coverage. Even if your plan carries a high deductible, your insurance will generally lower your out-of-pocket cost. If you have no insurance or choose not to use it, your urgent care center will usually charge a modest flat fee for treatment.

Bottom line: Urgent care fees are nearly always lower than emergency department or family practice fees.

Myth #4. Urgent Care Centers Only Treat Minor Ailments

While urgent care centers do treat minor ailments, the term “urgent care” can be misleading. Most urgent care centers also offer preventative health care such as screenings for disease, general physical examinations, and vaccinations (flu, MMR, Hepatitis, Tetanus, Diphtheria, Pertussis, Pneumonia, Polio, etc.).

Physical exams are offered for immigration, employment (DOT/CDL exams, drug testing, etc.), and school or sports requirements.  They also provide testing and treatment for STDs.

Urgent care centers usually have X-ray equipment and laboratories on site and can dispense routine medications.

Myth #5. Urgent Care Centers Don’t Interact with Other Health Care Providers

If you are concerned that your primary care physician won’t be informed about your urgent care visit, relax. Urgent care providers communicate regularly with family physicians, specialists, and hospitals. A complete record of your visit will be available to other providers as needed.

If there is any question about the nature of your care, the urgent care provider can contact your regular physician or specialist for consultation.

You can also rest assured that your health care privacy will be protected as required by federal and state law. Only other providers and your health insurance carrier(s) will have access to your records if necessary and as authorized by you.

Video Discussion

We are now posting live video discussions of important health care topics on Facebook and YouTube. To learn more about urgent care from Dr. Thomas Brown, check out the recent video on Facebook in which he announces the opening of a third Kathy’s Urgent Care clinic in Berlin, Connecticut. Learn why urgent care is expanding and how it can serve you and your family.

Cold or Flu: How Can I Tell the Difference?

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Got the sniffles? Sore throat? Body aches and pains? Fever? You might be suffering from a cold or the flu. But how can you tell the difference, and what can you do about either one? Winter brings greater exposure to cold and flu viruses and, therefore, greater risk of infection. It’s important to know the difference and how you and your family can cope.

Cold vs. Flu

It is often difficult to tell whether you or others have a cold or the flu. As the following chart shows, however, differences in symptoms are often apparent.

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Treatment

Colds

Usually over-the-counter (OTC) or home remedies can relieve symptoms of colds. There are a wide variety of OTC medications to ease nasal congestion, coughs, and mild fever. But with all OTC medications, be sure to observe label directions and dosage limitations. Do not exceed dosage limitations for acetaminophen (over 59,000 persons were treated for overdosing last year). And do not give aspirin to children or teenagers, since doing so following a viral infection can result in Reye’s syndrome.

Sometimes gargling with salt water relieves a sore throat. A sinus rinse or irrigation can relieve sinus congestion and discomfort. (NeilMed® offers several OTC sinus rinse products (such as neti pots) that can help relieve symptoms for colds and allergies.)

Other home remedies include chicken soup which can have anti-inflammatory ingredients and can help relieve nasal congestion. Honey, sometimes with lemon, when consumed in tea or alone, can relieve coughing.

Above all, rest and drink fluids.

Flu

Many of the same OTC or home remedies that relieve cold symptoms can help also with flu symptoms.

Since the flu and possible complications are more serious, medical attention is frequently required. To relieve symptoms, physicians sometimes prescribe an antiviral drug:

·      Oseltamivir (Tamiflu™), an oral medication

·      Zanamivir (Relenza™), an oral medication

·      Peramivir (Rapivab™), an injectable medication

These medications are not cures, but they can reduce duration of symptoms. They are most effective if administered within 48-72 hours of the onset of flu symptoms.

If you are pregnant, are over 50 years old, have a compromised immune system, or have a chronic disorder such as diabetes, you should seek medical attention if you get the flu. Because of the risk of complications such as bronchitis or pneumonia, you should see a clinical provider within 48 hours of the beginning of symptoms.

Prevention

Colds

It is almost impossible to keep from catching a cold. The rhinovirus can be transmitted by airborne droplets from infected persons who sneeze or cough. It can also be transmitted by direct contact with an infected person or surfaces that such a person has touched. Basic hygiene, such a frequent washing of hands, and avoiding contact with infected persons or surfaces (such as doorknobs, countertops, railings) are the best preventative measures. In addition, try to avoid touching your own eyes, face, nose, or mouth if you encounter others who have a cold or you are in a public place.

Flu

To reduce the chances of getting the flu, use the same measures above that help to prevent catching a cold. Also, you should know that a cold cannot morph into the flu because colds and the flu are caused by two very different viruses.

Very important: The most effective way to prevent getting the flu is to get a flu shot every year. While experts recommend getting a flu shot by the end of every October, you can still get a flu shot in the late fall or early winter. Peak effectiveness begins 2-3 weeks after you receive your shot. For more information about flu shots, see our recent blog, Get Your Flu Shot Now!

If you or your family have questions about symptoms and whether you have the flu, come to Kathy’s Urgent Care so that we can resolve your concerns. If you do have the flu, we can help you feel better and avoid complications, especially if you visit us within 48-72 hours of the onset of symptoms.

What Will your Visit to the Doctor Cost?

What will be your out-of-pocket cost for your next doctor’s appointment? Unlike most other transactions, learning what a health care procedure will cost before you receive treatment is extremely difficult. Providers charge different prices. Health insurance plans vary. Various aspects of health insurance coverage are difficult to understand. And much of the confusion might be intentional to boost corporate profits. Public discussion of these issues often centers on “transparency of health care costs.”

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How Health Insurance Coverage Varies

Most of us are aware that the health insurance landscape has changed. Premiums have increased for people insured by their employers and for those who purchase insurance through the Affordable Care Act (ACA) exchanges. In addition, higher deductibles (the amount that an individual must pay out-of-pocket before insurance payment kicks in) and higher co-insurance (the percentage of health care costs for which an insured person is responsible) amounts have shifted more of the financial burden to individuals. This shift has focused our attention on how much or how little our insurance will pay for particular treatments.

Your insurance carrier can inform you about your deductible amount, your co-payment, your co-insurance rate, and specific details about which treatments are covered.

Insurance companies also negotiate varied rates of payment with different providers—what is called a contracted rate. Sometimes the amount paid by insurance companies to clinical providers could vary by several thousand dollars, ranging from $12,000 to $75,000 for joint replacement surgery, or $1,000 to $6,500 for cataract removal. If your deductible or co-insurance amounts were high, you could be faced with large out-of-pocket expenses, depending on which provider performed the service.

Insurance companies typically do NOT publish their contracted rates for clinical providers.

Because of contracted rates, insurance companies often pay substantially less than the full price that a provider would otherwise charge. This is true especially for providers who are listed as “in-network,” that is, who have negotiated specific rates with insurers. If a patient receives treatment from an “out-of-network” clinical provider, however, the amount charged by the provider could rise to a sum close to what uninsured patients would have to pay.

Insurance companies inform their clients about the differences between in-network and out-of-network payments, but charges assessed by out-of-network clinical providers can still be far above what an insurance company will pay.

Medicare and Medicaid establish fixed rates of reimbursement to clinical providers for specific conditions and treatments. Most providers accept these rates, but a small number of providers have opted out of accepting Medicare or Medicaid rates altogether. Further information can be found at the Kaiser Family Foundation website.

Why Providers Charge Different Prices

Clinical providers often add to the confusion by charging different amounts. Reasons for such differences among providers include the type of practice or institutional setting, the geographic location of the provider which might reflect drastic differences in overhead expenses, including the nature of the clinical staff and medical equipment that must be maintained.

Sometimes, providers’ fees differ because of the professional qualifications of clinical staff who actually conduct a procedure. Differences in overhead expenses are often reflected on your bill as a “facility fee.” Most providers will not itemize the details contained in their “facility fee.” These differences go far to explain why services rendered in a hospital’s emergency department or in their own urgent care centers are so much more expensive than when delivered by an independent urgent care clinic.

Because of such disparity among providers, it is always wise to check with more than one to see what they would charge for the procedure that you require. Some providers might be reluctant to give you such information, or they might claim that they cannot foresee what the final charges would be because they cannot predict whether complications might arise. You should therefore be prepared to make a decision based on an estimate of what the charges might be.

What Transparency Means

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Confused? You should be! Understanding the ins and outs of insurance coverage and the differences among providers perplexes even health care experts. But some insurers and clinical providers have begun to provide relevant information in simpler form. And some states have started to require greater transparency in health care costs and even to provide tools to help those who need care and help with paying for it. Here is what such transparency should mean:

  • Insurers and providers should provide accurate, relevant price information, including what is and is not covered by insurance.
    • Some insurance carriers—for example, Aetna and UnitedHealthcare—provide online tools to help their members find estimates for hospital costs and medical procedures.
  • You should be able to obtain information about quality of care and patient experience for different providers.
  • Your clinical provider should include considerations of cost when advising you about undergoing certain procedures or treatments. These considerations should include costs of referrals to other providers and procedures not covered by insurance. After all, crushing debt due to unexpected medical expense can be toxic!
  • Do not presume that higher price means better quality of care. For a list of several resources that you can use to check on quality of care, go to the Commonwealth Fund’s Quality Matters Archive.

Ask Questions

Of course, if you are confronting an emergency, there is no time to ask questions. Otherwise, do not be surprised by your health care bill. Take charge. Ask questions. Assume responsibility for your financial as well as physical well-being.

The Healthcare Financial Management Association (HFMA) has prepared a complete and useful guide in plain language for you to learn what questions to ask and how to ask them: “Understanding Healthcare Prices: A Consumer Guide.” Click here to download the guide free of charge (also available in Spanish).

At Kathy’s Urgent Care, we try to be as transparent as possible about pricing, payment policies, and insurance. For more information, check out our Payment Policies and Insurance page, or call us. We’ll be glad to respond to any questions that you have.