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July 2014

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Emergency Room vs. Urgent Care Facility, How to Save Money

By | Health Insurance, Staying Healthy

While a dislocated shoulder or bad case of the stomach might feel like an emergency, many health policy experts are warning against going to the emergency room for treatment and suggesting a visit to an urgent care facility instead.

disabled-72211_1280In addition to potentially placing unnecessary demand on hospital staff, a visit to an urgent care center is often a much cheaper option – a concern for those with high deductibles and co-pays. In February, WFAA in Dallas reported a story on local resident Lisa Harvell who sought emergency room treatment for a painful case of shingles. Harvell told the ABC affiliate that she was shocked to see the bill for her treatment.

“It was $1,170,” Harvell said. “This entire bill just stuns me. I never expected this — ever.”

An Emergency Room Trip Equals Higher Costs for Everyone

According to Humana, a trip to the emergency room could cost up to six times more than a visit to an urgent care center. In a recent report, the health insurance company also said higher costs means greater average employer cost for an insured patient, average self-pay for the insured person and Medicare costs. These higher costs are much more alarming after considering that 84 percent of cases seen in emergency rooms are “not actual emergencies,” according to an NYU study cited by Humana.

How to Know Where to Go

To determine just what an actual emergency is, the National Institutes of Health has issued a series of recommendations for patients to consider when seeking care.

“How quickly do you need care? If a person or unborn baby could die or be permanently disabled, it is an emergency,” the NIH said on its website.

The federal agency listed numerous emergencies that warrant not only a trip to the emergency room, but calling 911 for immediate assistance from a team of first responders. These emergencies include: stopped breathing, head injury with loss on consciousness, spinal injury, powerful electric shock or lightning strike, severe burn and a seizure that lasts three to five minutes.

The NIH also listed numerous situations that simply call for a trip to an urgent care center, including: common illnesses, such as the flu, and common injuries, like minor cuts or broken bones. The NIH added that patients should call their doctor if they aren’t sure their situation calls for a trip to the emergency room. If the doctor’s office is closed, his or her answering service should be able to provide the necessary assistance.