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As I negotiate down expensive facility bills for my clients or fight insurance companies for higher reimbursements, I am often struck by the number of patients who thought the emergency room or the specialist’s office were their only choices. Minor episodes end up costing thousands of dollars when more affordable options were available.
Here are some alternatives to costly ERs:
1. Urgent care centers
Staffed by doctors, these facilities treat less severe emergencies that require immediate attention. Services include sutures, prescribing medications, chronic condition management, health evaluations, imaging, stabilization until your next doctor appointment and more.
Urgent care centers are found in many cities and neighborhoods. Appointments are not necessary.
2. Retail health clinics
Addressing minor concerns such as allergic reactions, minor infections, wound care and skin conditions, these clinics are staffed with nurse practitioners licensed to prescribe medications and perform simple medical procedures. This is a good alternative to a doctor’s visit for general and school health exams or for vaccinations.
Located in drugstore chains, such as CVS, or retail stores, such as Wal-Mart, they contract with most major insurers. Their services are fairly priced.
3. Nurse helpline
This free service from your insurance provider, staffed by nurses 24/7, can save you the cost of a doctor’s visit. Find the number on your card or on the insurer’s website.
Call to determine if you need to go to the ER, to find the nearest “in network” urgent care, to ask what remedy is best for minor symptoms, to treat an illness or to get first aid advice that does not require urgent care. These nurses can provide answers when your doctor’s office is closed, help coordinate medical care if you are away from home, or order urgent prescription refills when the doctor is unavailable.
4. Free or low-cost clinics
Offering a variety of services, these clinics should not be your first choice in case of an emergency. Administered by your county, privately run or belonging to teaching universities and hospitals (services are rendered by students under the supervision of experienced doctors), waits can be long but prices make them worth a look.
Some specialize in a specific illness (HIV/AIDS clinics) or services (women’s health clinics). Exams, prescriptions, tests and more are provided at significant savings.
Depending on the test, you may need to consult your doctor first. Many common tests can be obtained without a prescription, or at a lower cash cost than in the office, directly from labs such as SaveOn Labs, DirectLabs and Quest Diagnostics.
If you have a minor sports injury or joint pain, or want to avoid surgery, consulting a chiropractor is a less costly option than seeing an orthopedic doctor. Specializing in bones, muscles and joints, they use more conservative, less drastic treatment methods (spinal manipulations, physical therapy, medical massages) to get you back in shape. They can order scans and limited labs. Expect to pay $50 to $80 per visit (including all modalities). This is often a covered insurance benefit.
Ask the pharmacist at your local drugstore or pharmacy for a recommendation on what over-the-counter remedy is best for minor ailments, to check on possible negative interaction with current prescriptions, or advise on a minor allergic reaction. Local and chain pharmacies also offer low-cost flu shots and other vaccinations.
8. Online physicians
The number of online doctors is increasing. Sites such as MeMD, InteractiveMD and the Online Doctor offer virtual encounters for set prices and at convenient times for patients.
Remember to ask any health care provider or clinic you may consult if they are part of your insurance network. Choosing one who is contracted with your insurer will significantly lower your bill. You may need to send the bill directly to your insurer; getting a “superbill” (specialized medical bill) is essential. If you self-pay, this receipt or statement will be useful come tax season.
Please note the information here does not intend to provide or constitute medical care or advice. It neither endorses nor promotes any service or provider.
ALWAYS call 911 or go the emergency room if you are having a life-threatening emergency or if your health may be at serious risk by delaying care.
Never jeopardize your health by denying yourself access to urgent medical care whenever necessary. Although solutions may be more limited after the fact, there are still ways to help lower high medical bills.