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Emergency room rates at urgent clinics vexes area patients

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TWC News: Emergency room rates at urgent clinics vexes area patients
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A.J. Padilla says he was pretty pleased with the service he received in January of last year when his then one-and-a-half-year-old son showed signs of an ear infection.

“Went in quick. We were seen real quick,” Padilla said. "We went to an urgent care facility to take care of something that needed attention, but wasn’t anything that was going to kill somebody.”

However, when Padilla went to check out of St. David's Urgent Care clinic and was asked to pay his emergency room co-pay, he started asking questions.

“’What if I’m having a heart attack and I get brought there, what’s your transport? How do you guys do that?’ ‘Well we have a procedure,’” Padilla said. “Basically they call 911. The irony being the fire department shows up--me."

Padilla is an area firefighter and EMT.

He ended up paying a $100 co-pay and agreed to also pay the doctor's fee so his son could get the prescription.

Padilla then filed complaints with St. David's, the Better Business Bureau, and the Texas Attorney General’s office. He also contacted his local representative.

“There was nothing ER about this place,” Padilla said. “There’s no ambulance receiving facility transport in or out.”

Online reviews of St. David's urgent care clinics are less than favorable when it comes to cost.

St. David’s is within its rights to classify its urgent care clinics as Level B Emergency Rooms. The clinics are, in essence, extensions of the closest hospital location. While the clinics do display signage explaining that, most patients, especially in a time of need, do not notice the fine print out front.

“When you go and you show up and it says ‘urgent care clinic’ in big letters on the front of the building, it sounds like you’re going to an alternative of the emergency room that’s not going to be as expensive," Blake Hutson with the Consumers Union said.

According to the Urgent Care Association of America, cost for treatment at an urgent care center is usually comparable to a primary care visit, and less than the emergency room. In Texas, there's no regulation defining 'urgent care.'

In a statement, the hospital’s Senior Vice President said, "Staff members at St. David's Urgent Care facilities work to communicate clearly. When a patient arrives, the first priority is to assess his or her health needs to determine the most appropriate care. Immediately following, staff explains to each patient -- the potential out-of-pocket costs."

While Seton’s health system does not operate any urgent care clinics, Scott and White has one clinic in Round Rock.

According to their staff, they charge urgent care fees and are not classified as a Level B emergency room.

Only two states, Delaware and Illinois, regulate urgent care clinics. Click here for an accredited list of urgent care clinics.

Full statement from St. David's HealthCare:

"St. David's Urgent Care facilities are Type B or Provider-Based Emergency Departments, which means each is an extension of a St. David's HealthCare hospital with a higher level of service than what is found in a typical urgent care center. This includes having a board-certified emergency medicine physician on site during all hours of operation, in addition to having on-site radiology. Although insurance coverage varies by carrier,some insurance companies consider treatment at these facilities an emergency room visit, while others consider the centers urgent care facilities and cover the services accordingly. Patients should consult their insurance carrier about specific coverage.

"Staff members at St. David's Urgent Care facilities work to communicate clearly. When a patient arrives, the first priority is to assess his or her health needs to determine the most appropriate care. Immediately following, staff explains to each patient that he or she is in a Type B Emergency Department and the potential out-of-pocket costs so that the patient may decide if this is the most appropriate setting for care. This is also provided in writing to each patient, individually. If a patient chooses to leave at this point, there is no charge to the patient. In addition to discussing billing with patients upon registration, it is discussed again prior to a patient's departure. Each St. David's Urgent Care facility features signage on the front door and in the waiting room indicating that it is a department of a specific St. David's HealthCare hospital."


---Mark Clayton, Senior Vice President, St. David's HealthCare

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