Urgent Care Price Without Insurance

This post is going to review the urgent care price without insurance — the urgent care cash price.  How much is it — and is it worth it?

Urgent Care Price without Insurance:

I had big plans for my Saturday.  Plenty busy with loads of activities for my high schooler, things to buy, places to be.

{mom, my throat really hurts}

I take a quick peek at with a handy flashlight and it looks suspect… so I pull my handy dandy strep test out and…

It’s positive.

{sigh}

{big, fat, sigh}

Sadly, the strep tests don’t come with a doctor to prescribe for you, so it was off to urgent care we went (you can find out more about strep throat here).

Urgent care is great on the weekends for something like this.

A)  I knew she needed antibiotics , and I wanted them quick so she wouldn’t have to miss school.

B) It’s WAY cheaper than the emergency room — when just a few years ago that would have been my only option.  Phewsh.

At the time, ur family had a high deductible health care plan.  That means we pay all of our medical costs up to $X,000 (for us it’s 5k).  Hence, I am probably more careful than your average person who just has a little higher copayment.

Cash pay urgent care

When I got to the registration desk I asked if they knew if it was cheaper to just pay cash or to submit it to blue cross.  Now, Blue Cross is a super normal insurance here. Most places take it.  It should be something they should know.  They had no idea, and of course — because it was a weekend (or, frankly, any time you’d need to use an urgent care) there was no one to call to find out.

So, I paid the $125 cash price.

You might wonder — does urgent care take cash — or do you HAVE to have insurance?  You can 100% pay cash.  It’s WAY easier for them, they should welcome it.

And we were seen.  The nurse practitioner was lovely, and after looking at Princess P’s throat, she decided that she didn’t need to do her own strep culture (which saved me $25).   She maybe spent 4 minutes in the room?

For $125 bucks….

Then, it was off to the pharmacy where we got a pack of penicillin for less than 10 bucks, for 10 days.

Horray!

The following Monday I called their billing office to find out how much it would have been if I had just used my insurance.  They couldn’t tell me.  They told me to call back in a week.  I guess the visit wasn’t in their system yet.

I called back a week later and they were still incredibly vague about what they had done and what they would have billed (or who the provider was).  In fact, I believe that they are getting a GREAT deal when I pay cash because billing, apparently does absolutely nothing with it at that point.  So, after about 6 phone calls I found out that it is LIKELY that if it had gone to my insurance, my portion of the bill would have been $141.  However, they mentioned that what they would LIKELY have billed is supposed to come with at least a 30 minute face-to-face time and a pretty detailed case.  She saw her for 3 minutes, checked her throat and ears and wrote a prescription.

Honestly, if she had billed that code I would have disputed it.

Urgent Care Billing

And here’s a dirty little secret.  Doctors up-bill.  Because no one notices it.  But, I’m going to look up the codes from now on to see if they’re being honest.

ALSO, if you ARE going to pay cash the doctor (or provider) should still be willing to fill out the form for the insurance (which you should be able to find on their website) that tells what they did and the codes.  Then, you submit it so that amount gets applied to your deductible.  This would be important if you later end-up meeting your deductible (it wasn’t as important as we were almost to a new year and I knew we wouldn’t be hitting 5k without some serious bad luck).  If you plan on paying cash I’d recommend calling your insurance and find out where you can get the form.  My insurance knew just what I should do.

Then, about 14 days later the strep came back.  We visited our regular doctor who recommended that we pay the full cash price of $85, and that visit only ended-up costing $65 (so, we have a credit with his office for next time — I wish I would have just waited to pay until it went through insurance).

In summary, I think next time I am likely to just send it to the insurance for something as small as this.  I’m also going to check their billing codes to see if think they are fair and if not, I will contact their billing office for proof that they saw me for 30 minutes.

BUT, I think it’s usually smart to ask what the cash price is.

I just WISH that somehow they could tell you what the price is going to be.  I wish Urgent Cares could/would advertise that they will do a visit for $XX so we could compare.

It’s so hard.  And that benefits the doctors offices tremendously.

With my regular doctor I get the benefit of him seeing me and catching anything else.  Unless it’s urgent, I say wait to see your regular doctor, as often as possible. Also, I think I would always take a child until they’re about 8 into Urgent Care.  I don’t want to miss a ruptured ear drum or something else I’m not noticing.

I’d encourage you to ask your regular doctor what they recommend you do when they’re not in office hours.  They might have a good idea what you should do (or perhaps, just recommend you call in).

Either way, I was glad to get her on antibiotics, she was on it quick enough she even made it to church the next day.  After 24 hours on antibiotics, you’re no longer contagious with strep.

**Never take something you've read on Pulling Curls over the advice of your doctor.  Also if you think you have a real emergency call 911 or go to an ACTUAL emergency room (preferably one tied to an actual hospital).

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