Not sure why you received a medical bill when you have health insurance? Most insurance plans now have soaring deductibles and unless those deductible amounts are met, your plan will not cover the cost of treatment. These annual deductibles commonly start in January or when your plan is due for renewal. So, how do you safeguard yourself from a large medical bill when you have a deductible? Most people do not realize that hospitals and large medical practices have the ability to negotiate higher reimbursement rates with insurance companies. How does that affect you? Well, whatever they bill your insurance plan simply gets passed on to you, if you have a deductible. Data indicates that the negotiated rate of “Big Chain” Urgent Care Centers (20 or more locations) is often significantly higher than that of smaller urgent care centers. In other words, if a small Urgent Care Center bills $100 – $150 for an office visit, it is very likely that the large chain and hospital affiliated or owned urgent care centers can bill upwards of $350 – $400 for the same visit.
Patients using hospital based or big chain Urgent Care Centers can easily get stuck with bills of several hundred dollars when they get referred to doctors or specialists within the hospital network, a common practice. Patients are typically asked to go to hospital affiliated imaging facilities and labs for all kinds of tests and procedures. The more services a patient uses within their network, the more opportunities they have to generate billable services. So, what can you do to protect yourself in a system like this?
Rather than being surprised, find out your potential financial liability before you go to a Big Chain or hospital based Urgent Care Center by calling your health plan and asking them the contracted charges. You will be surprised when you compare the discrepancy in billable charges of big chain or hospital based urgent care centers to small privately owned urgent care centers.
Because we are a small local entity, insurance companies do not make it possible for us to revise or re-negotiate our contracted rates, we still bill at rates that were offered to us a decade ago! How do you gain from this? Since we have lower contracted rates the amount applied to your deductible is also smaller resulting in lower bills. In other words, since hospital based and big chain medical practices have higher contracted rates with insurance companies, patients get significantly higher bills for the same services. Additionally, we are not affiliated with any hospital or large medical group so we only have your best interest and convenience in mind when we refer you to labs or specialists. Our referral list is updated based on feedback received from our patients.
Hospital based and big chain urgent care centers have aggressive teams to follow up on late or unpaid bills. They tend to follow strict protocols which send patient information to collection agencies in just a matter of time. Being a small entity, we have the flexibility to provide personalized and convenient payment options to patients who are unable to take care of their bills right away. We refrain from harassing patients with phone calls and NEVER jeopardize their financial well being by sending them into collections. By being aware and making informed choices, you can safeguard yourself from large unexpected medical bills.