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A Patient's Guide to the Growing Menu of Healthcare Options


Urgent care? Walk-in clinics? Free-standing emergency rooms? With all of the new clinic types, it can be difficult for patients to know where to go for a given medical problem. Here's a simple guide.

Practice Management, urgent care, healthcare

If you are like most patients, you are confused about where to go for care when you think you have a sick-care problem. The menu is getting increasingly confusing and making the wrong choice can not only be bad for your health, but devastating to your bank account.

Here are some guidelines and suggestions:

1. Now is the time to increase your sick-care insurance or uninsured IQ. Call your insurance company after you finish reading this and find out which facilities are included in your network, how much you have to pay in co-pays and deductibles, and the locations of the nearest point-of-care options. If you are uninsured, take time to some homework to see if you or your children are eligible for Medicaid, ACA plans, or other coverage benefits.

2. You are caught in a dilemma. Given the financial risk, you should not engage the sick-care system unless you must. On the other hand, an ounce of prevention.... Whether and where you do should be an informed decision, not left up to chance or circumstances that limit your options.

3. Do not depend on providers to do a good job with handing you off to another provider for follow up care after being seen in an urgent, semi-urgent, or emergency point of care. Take personal responsibility for following up and making necessary arrangements and compliance.

4. Retail-based clinics, urgent care centers, free-standing emergency rooms, physicians’ offices, advanced practice primary care clinics, and neighborhood health centers are designed to provide different levels of service for different problems with varying levels of intensity. Visit these places near you before you need them and find out what they do and if and when it would be appropriate for you to visit if and when you need them. Who staffs them?

5. Use online resources to help educate yourself about your health conditions and where to go for care. Raise your medical IQ now.

6. Understand that visiting a free-standing emergency room is like visiting an emergency room attached to your hospital.

7. Be careful that you are not referred to an out-of-network provider for follow up, particularly if your insurance has a limited network of providers.

8. Negotiate price and offer to pay in cash.

9. Don't expect to be provided with an accurate price list.

10. Question the timing, location, and necessity of lab and imaging tests

Unfortunately, patients are becoming increasingly vulnerable to the impact of high co-pays, deductibles and the escalating cost of care and drugs. You owe it to yourself and our family to have a plan before you need it.

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