Community Chat

[CouponQueen]

Our ER copay is $60 and the hospital will give you a 5% discount if you pay at the time of the visit.

We also have a few Emergency Clinics open up withim the last five years. They have limited -hours though on the week-end. 8 am to 4 pm they need to be open 24/7.

I was talking to somebody who runs the clinic and they said the 24/7 idea is great but they don't have the resources to pay staff around the clock and it is costly to keep full staff on. They do not have lab or pharmacy but a local neighboring town has a couple 24-hour pharmacy's about 15min away.

Insurance is accepted but the reimbursement rate is not a lot it is not cost effective.

I don't know the answer.

staffing with Med Student's - PA is ehhh as who wants that chance it is one thing when they are attached to a teaching hospital and supervised by a MD but to be out there on their own at 2 am in the morning. Most people who would rush out at 2 am for being sick would want the security of an ER ..

[Lipstickdiva]

On 1/3/2014 terrier2 said:

On 1/3/2014 RetRN said:

Our Urgent Care closes at 7pm and our pharmacies close by 9pm. I wish the Urgent Cares could be open 24/7 and have pharmacies on site. If those things could be done along with some type of transportation service I think life would be good. I know, I'm dreaming.

It's not a dream.

Our urgent care centers are open 24/7 and some now have vans.

Our Walgreens are open 24/7 too...at least the city stores are.

Our Walgreens store is open 24/7 however, the clinic has pretty limited hours. They are open M-F from 8-7:30 and Sat and Sun 9:30-5:30.

The only urgent care facility is my area is opened M-Sat 9-8 and Sun 10-6.

[SoX]

On 1/3/2014 Irshgrl31201 said:

I live in Raleigh and we have many low cost/sliding scale clinics that have labs on site. They have to wait a little longer for their pharmacy but only by an hour and in most cases the drugs are free or greatly reduced.

I was watching the news last night and they were talking about a study that showed people who have Medicaid are 40% more likely to use ER services that those that have no insurance even if their illness doesn't meet ER criteria. I don't understand why they would use the ER if they have insurance to see a doctor especially if it isn't an emergency.

Must have been the same study Dagna referenced on a now defunct thread. You partly answered your own question, though ... they're on Medicaid, not exactly the Lexus of insurance plans. Some don't have a primary doctor ... remember, there are lots of doctors who don't take patients with Medicaid.

It's also a behavior that dates back decades when uninsured folks had to go somewhere for medical care ... some (not all) emergency rooms were the only places that wouldn't turn them away. As I said on the other thread, it's a learned behavior ... it can be "unlearned" if the ACA gets a chance to put in place certain guidelines and requirements.

[CouponQueen]

In my work life I deal with many ambulances and they do not worry about bills etc. they are the low paid people saving lives and doing their job.

The ambulance companies do schedule transports to make money. That is where they are guaranteed x amount of dollars. These trips are pre scheduled and pre authorized. Be it from a hospital to Nursing Home..to Hospital to Hospital...to psych to psych etc. I have received many calls where the scheduled transport was going to be late due to a car accident etc as those types of emergencies of course come first and scheduled transports last even scheduled.

Medicaid reimbursement is really low not many MD's want to accept it.

I also know somebody who had medicaid and used the ER as their personal physician and I asked why..."why not, I can get in anytime I want and no cost.." she lived in a small town where no Urgent Care without driving and the ERs were not overwhelmed.

I think we are jumping the gun here. I think we need to give this time. It is a start and not fool proof or perfect but a start..and things that come up will be resolved over time.

As for insurances being dropped they need to lay blame where it is..on the policy for not stepping up and covering what is required. I know my insurance automatically started covering new provisions. It was on their website. They didn't sent out notices lol but my daughter went to their website looking for something and noticed things were listed as being covered...We need to give this time to work out all the problems and snags.

Nothing is perfect on the initial roll out especially with so many questions and things cropping up...as for the ER issue..this is what day 3 and we know these things already..and I love when people say "I read.." well you know what I can find three articles stating just the opposite if I want that is the way it works. Same as "sources say...." LOL...why people think using this arguement is any more worthy then another doesn't make sense lol..

My husband has a MD that is always booked and to get in right away they need to move others around..my MD has open appt's with usually their PA or NP and I do take them as I am going for a cough or rash etc. I have good insurance and don't need referrals etc..I can call up and go to any speciality for the same co pay ..so I have my own MD's for their own speciality..

[Irshgrl31201]

On 1/3/2014 Sox2 said:

On 1/3/2014 Irshgrl31201 said:

I live in Raleigh and we have many low cost/sliding scale clinics that have labs on site. They have to wait a little longer for their pharmacy but only by an hour and in most cases the drugs are free or greatly reduced.

I was watching the news last night and they were talking about a study that showed people who have Medicaid are 40% more likely to use ER services that those that have no insurance even if their illness doesn't meet ER criteria. I don't understand why they would use the ER if they have insurance to see a doctor especially if it isn't an emergency.

Must have been the same study Dagna referenced on a now defunct thread. You partly answered your own question, though ... they're on Medicaid, not exactly the Lexus of insurance plans. Most don't have a primary doctor ... remember, there are lots of doctors who don't take patients with Medicaid.

It's also a behavior that dates back decades when uninsured folks had to go somewhere for medical care ... some (not all) emergency rooms were the only places that wouldn't turn them away.

Medicaid gives out that info whether on paper or by website that shows the doctors that accept Medicaid, they do this upon approval. I dont exactly live in a huge town and there are many many doctors that accept Medicaid. I know many girls on it because of my charity and Medicaid pays for a lot of things that regular insurance plans don't. Many don't even make the effort to find a GP, they wait until the last minute and when they can't get worked in immediately they go right to the ER. I have seen it happen with my own eyes with the girls and we have to keep on them to pick out a GP and go to the initial exam appt so they are in the doctors system so when they do have an illness come up will be easier to get into see the doctor.

[AnikaBrodie]

There are a few Urgent Care Clinics (I think that's what they call them) in my area. However, I think depending on the medical issue a person could still end up in the ER.

[151949]

My PCP's office is a walk in clinic but he is the only doctor there so it has limited hours. I don't think there is anything like an urgent care in this town, so the community hospital is all that is open at night. My medicare advantage plan has a $125 co pay for an ER visit but it is forgiven if you get admitted to the hospital.

[SoX]

On 1/3/2014 Irshgrl31201 said:

On 1/3/2014 Sox2 said:

On 1/3/2014 Irshgrl31201 said:

I live in Raleigh and we have many low cost/sliding scale clinics that have labs on site. They have to wait a little longer for their pharmacy but only by an hour and in most cases the drugs are free or greatly reduced.

I was watching the news last night and they were talking about a study that showed people who have Medicaid are 40% more likely to use ER services that those that have no insurance even if their illness doesn't meet ER criteria. I don't understand why they would use the ER if they have insurance to see a doctor especially if it isn't an emergency.

Must have been the same study Dagna referenced on a now defunct thread. You partly answered your own question, though ... they're on Medicaid, not exactly the Lexus of insurance plans. Most don't have a primary doctor ... remember, there are lots of doctors who don't take patients with Medicaid.

It's also a behavior that dates back decades when uninsured folks had to go somewhere for medical care ... some (not all) emergency rooms were the only places that wouldn't turn them away.

Medicaid gives out that info whether on paper or by website that shows the doctors that accept Medicaid, they do this upon approval. I dont exactly live in a huge town and there are many many doctors that accept Medicaid. I know many girls on it because of my charity and Medicaid pays for a lot of things that regular insurance plans don't. Many don't even make the effort to find a GP, they wait until the last minute and when they can't get worked in immediately they go right to the ER. I have seen it happen with my own eyes with the girls and we have to keep on them to pick out a GP and go to the initial exam appt so they are in the doctors system so when they do have an illness come up will be easier to get into see the doctor.

I notice you didn't quote the last portion of my post ... "it can be unlearned" once the ACA guidelines are up and running.

"Many don't even make the effort to find a GP ..." I guess this is exclusive to your "charity"... otherwise why mention it. "Medicaid pays for a lot of things that regular plans don't" ... I don't know this to be true in my state; but it's the low and slow reimbursement that prompts doctors not to accept patients in most instances.

[Irshgrl31201]

On 1/3/2014 Sox2 said:

On 1/3/2014 Irshgrl31201 said:

On 1/3/2014 Sox2 said:

On 1/3/2014 Irshgrl31201 said:

I live in Raleigh and we have many low cost/sliding scale clinics that have labs on site. They have to wait a little longer for their pharmacy but only by an hour and in most cases the drugs are free or greatly reduced.

I was watching the news last night and they were talking about a study that showed people who have Medicaid are 40% more likely to use ER services that those that have no insurance even if their illness doesn't meet ER criteria. I don't understand why they would use the ER if they have insurance to see a doctor especially if it isn't an emergency.

Must have been the same study Dagna referenced on a now defunct thread. You partly answered your own question, though ... they're on Medicaid, not exactly the Lexus of insurance plans. Most don't have a primary doctor ... remember, there are lots of doctors who don't take patients with Medicaid.

It's also a behavior that dates back decades when uninsured folks had to go somewhere for medical care ... some (not all) emergency rooms were the only places that wouldn't turn them away.

Medicaid gives out that info whether on paper or by website that shows the doctors that accept Medicaid, they do this upon approval. I dont exactly live in a huge town and there are many many doctors that accept Medicaid. I know many girls on it because of my charity and Medicaid pays for a lot of things that regular insurance plans don't. Many don't even make the effort to find a GP, they wait until the last minute and when they can't get worked in immediately they go right to the ER. I have seen it happen with my own eyes with the girls and we have to keep on them to pick out a GP and go to the initial exam appt so they are in the doctors system so when they do have an illness come up will be easier to get into see the doctor.

I notice you didn't quote the last portion of my post ... "it can be unlearned" once the ACA guidelines are up and running.

"Many don't even make the effort to find a GP ..." I guess this is exclusive to your "charity"... otherwise why mention it. "Medicaid pays for a lot of things that regular plans don't" ... I don't know this to be true in my state; but it's the low and slow reimbursement that prompts doctors not to accept patients in most instances.

I didn't select what part of your post came up, I simply hit quote and that is what is what I responded to. I noticed that is was edited, perhaps you added that after I hit quote?

I have certainly noticed this with my charity because I have helped them sign up for a GP. There is a feature where you enter how far you are willing to travel (mile wise) and it lets you know how many doctors are in that area that accept medicaid. We had a lot to choose from. As for it being only my experience, that could be. I can only speak of what my experiences are. I will say that I work with a case worker for the girls in the charity who has helped me out in finding programs, services, etc and it is her experience too. She says a lot wait to pick out a GP because they arent sick at that time and they wait so long that when they are really sick they are forced to go to the ER because they cant get in. Had they even tried to get in a see the doctor though their doctor would refer them to NEXT Clinic or another type of urgent care that accepts Medicaid if their doctor was unable to fit them in immediately. I know this because it happened about two months ago. One of my girls was accepted for Medicaid, had an appt to see her GP and missed it because she said she wasn't sick so she simply didnt go. Since she had missed the appt she didnt have a GP because her doctor requires an initial visit to become a patient. Anyway had she had an initial visit and then she became sick and required an immediate appt and he couldn't have worked her in he would have given the OK to medicaid to let her go to NEXT clinic and be seen. Becuase she hadnt gone to the appt he would not give approval to go to the Urgent Care so she went to the ER for a strep infection.

Listen, I suffer from Crohns and there are many times I would have rather gone to the ER because I can get everything done there. Like I always have to get a CT scan, but when you see a regular doctor you have to go to the doctor and then go for an appt to get a CT scan and then go back to the doctor which can sometimes take 4 or 5 days. When you go to the ER you get it all done at once. It is easier to get it all done at once I agree, but unfortunately my insurance won't cover that. I feel like an idiot sometimes having to get after a grown adult with children to make an initial appt with a GP so she isn't in a position where she has to go to an ER when sick with a simple illness but I have to do it with almost everyone of them. I think after this last trip to the ER she sees the importance of the initial visit with her doctor. If she had seen him she would or had an hour visit at the Urgent Care (if he could not have taken her immediately) and she would not have had to spend 8 hrs in the ER and miss a complete day of work. Hopefully that was enough to show her the importance of it.

[raven-blackbird]

OP...............I think your proposal is valid.......I also think it's naive........medical facilities that stay open 24/7 with attached pharmacies are a recipe for disaster..........these facilities, I'm guessing would be more needed in lower income areas........areas where drug abuse is rampant and you just placed the "candy store" within easy reach 24/7....ever ask yourself why local pharmacies don't stay open late into the night????.....these are also areas where one would see a greater percentage of trauma cases, cases that would require more care then could be provided at a clinic environment.........people visits ER's because they have to be seen and these people that go to ER's for basic health care do so because don't have health care or the means to pay for services.......................................................raven