What is urgent care vs. emergency care?

An urgent care center typically treats non-life threatening conditions, some of which include common colds, flu, strep throat, and lacerations.

An emergency room treats more severe conditions, some of which include chest pain, abdominal pain, dehydration, and complex fractures.

Sometimes, it’s difficult for you to know which level of care fits your situation. With both under one roof, you don’t have to decide.

We are equipped to handle serious emergencies as well as lower acuity concerns –and bill at the rate for the appropriate level of care provided.

No. We require additional acknowledgement to avoid surprises.

Are you in-network with Medicare and Medicaid?

We are in-network with most major insurance plans, including Medicare and Medicaid. Learn more about our insurance and billing policies.

What is a new patient designation?

Insurance plans, including Medicare, specify first visits in an office or urgent care setting. The new patient visit typically is reimbursed at a slightly higher rate than subsequent visits to the same location, due to the additional work required to set up new records and obtain necessary information. Established patients are those who have been seen at the office or urgent care in the past three years, and the visit charge typically is less than the new patient visit charge.

How are patient charges determined?

Your insurance company negotiates rates on your behalf with providers such as us, and agrees upon rates they feel are reflective of the value provided to their members. Factors that may determine your plan rates could include quality of care, accessibility, and patient experience.

What is the difference between my Explanation of Benefits (EOB) and my invoice?

An Explanation of Benefits (EOB) is something the insurance company sends you to explain what is allowed by their policies, along with the associated charges. It is not a bill; rather, it is a communication from the insurance company to the patient. It may or may not correspond directly to your final bill. If at any time you have any questions or concerns, we can help sort those out for you. Connect with us here.

What is in-network vs. out-of-network?

In-network means we have a contract with your insurance company and have agreed on the cost is for  services provided to you. Out-of-network means we do not have a contract with your insurance company in setting the rates. As a result, you may be billed a different rate, which is determined by your insurance company and benefit plan.

For emergency care, state law requires that all patients be treated regardless of their insurance plan or ability to pay.

How do I get help in understanding my Explanation of Benefits or invoice?

If you have any questions or problems with your billing documents, we are happy to help you. Sometimes appeals may need to be filed with your insurance company; other times you may need to call your insurance company directly. If you have questions about your bill, your EOB, or your health coverage, connect with us here.

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