We would like to take this opportunity to welcome you to Doctors Urgent Care. Our mission is to provide high quality health care services by Emergency Medicine Physicians in a friendly clean environment on a walk in basis.
If you believe that you are suffering from a life threatening, or serious emergency please let us know. We are well equipped to handle most situations but there are times that an Emergency Room may be the most appropriate place to provide the care that some patients need.
Please take the time to review the information provided in this document as it may answer many of the questions that are commonly asked during and after your visits. We are here to help you. If you do not understand something, or are unsure of what is happening, please ask.
For our insured patients:
One of the most common misconceptions today is that your insurance company will pay for your needed care. There have been many commercials and advertisements recently run that seem to indicate that covered patients are happy consumers. Many consumers find that they are responsible for an ever increasing portion of the cost for care they need, while the insurance company collects the premium and make huge profits.
When you register to be seen, we use the information made available by your insurance company to advise you of your cost. We do require that co-pays, deductibles, and co-insurance be paid at the time of service. We want you to know that we work to get your insurance company to pay their share. This may require some work on your part. You may receive a questionnaire from your insurance company requesting additional information following your visit. In many cases, if the information is not provided within a very short period of time, your insurance company may reject the claim and tell us to bill you for the service. We suggest that you retain a copy of the completed questionnaire. If you have any questions, or need any assistance in completing these forms, please feel free to call us. We want you to get the benefits you pay the insurance company for, but are often unable to do this without your assistance.
Refund Policy for Insured Patients
We do our best to collect the proper amount of money at the time of your service. We utilize the tools and technology provided to us by your insurance company. We sometimes find that the information provided was not accurate or up to date. When this happens we will provide you a refund automatically. You should receive a document commonly called an Explanation of Benefits (EOB) from your insurance company several weeks before we do. Please review these when they arrive in the mail. If you are due a refund, we gladly issue a refund without your having to contact us.
You should expect to get a refund check from us within two (2) months of your service. You may wonder why it takes so long. Generally speaking, most claims are transmitted to the insurance company within two (2) weeks of your visit. The time it takes your insurance company to process your claim is completely out of our control. Once we receive our copy of the Explanation of Benefits we try and get them processed within several business days. After the claim has been correctly processed by your insurance company, and payment been received, we start to work on your refund. The refund checks are printed and sent with our bills on a monthly basis. Please feel free to contact us if you have any questions regarding this, or any other matter.
For our Cash or Private Pay Patients
Our prices reflect a significant discount. Our Physicians treat you with the same respect and dignity as insured patients. Our pricing discounts are set up so that you do not pay for the cost of having to deal with an insurance company. You always have the opportunity, and are strongly encouraged to inquire as to the cost of services and tests ordered on your behalf. We feel that an educated consumer is the best kind.
Lab and X-RAY
We have some of the most advanced and cost effective equipment available to perform the most commonly needed examinations and tests our patients frequently need. We are able to perform x-rays and most commonly needed labs in our office. If you require advanced diagnostic testing such as CT, or MRI, we will assist you in obtaining the care that you need in the most appropriate setting. If you are insured, your insurance company may be the single largest obstacle in obtaining this care in a timely manner. Most insurance companies require these tests to be pre-authorized. Our x-ray equipment is digital. This means that we do not use film. If you receive an x-ray, a CD containing the x-rays will be provided to you. Most, but not all physicians that we may refer you to will accept the CDs for your follow up care. If you do follow up with a physician that requires a film version of your x-ray, we are able to print these. The cost for film is currently $10 per sheet. This is our cost; there is no mark up on film. Some x-ray studies will require multiple films to print.
We do have a lab on site in which we are able to perform the most commonly needed tests for the rapid diagnosis of your condition. We do however send out samples for culturing and additional lab work. If you are being seen and treated for potentially infectious conditions please know that we will most likely send a sample for culture. We will send your insurance information to the lab, with your sample, and you will be billed for these services directly from the lab. You may ask why we send these samples. The answer is to insure that we have prescribed the most appropriate medication and treatment for your condition. There are many drug resistant infections. We generally try the most cost effective antibiotic or other mediation that is indicated for your condition first.
Although you will receive a bill from the lab that performs the culture, or other required test, you will be contacted by a member of our staff with the results. It sometimes takes several days to get the final results from these labs.
As an added convenience we are able to fill most of the prescriptions that you may receive while you are here. We do not file insurance for prescriptions filled in our office, but will provide the documentation you need to file with your insurance company. With your receipt and a form available from your insurance company, you may find that our drug prices are less than your co-pay at major pharmacies. This not only saves you time, but may also save you money.
State law does limit the amount on controlled substances that we may dispense. Generally the amount of these controlled drugs is an adequate supply. You may also get an additional prescription that if needed, may be filled at a local pharmacy.
Discharge InstructionsNear the end of your visit you will be given a copy of the discharge instructions. These contain useful information that will assist in your recovery. Please take the time to review them as many of the questions you may have and forgot to ask during your visit may be answered. They will also contain the name and phone numbers to any physicians we may refer you to for follow up care, such as a specialist. We will be sending a brief summary to the physician to whom you were referred, as well as your primary care physician (PCP)
Frequently Asked Questions
Question: Why do I have to present my ID and insurance card for each visit?
Answer: For your protection, we are required to verify your identification and insurance eligibility for each visit. It is very important that when you receive a new insurance card, that you have it for all of your doctors. Your signature acknowledges that you have given us the most accurate information.
Question: I was told I needed a referral, and why are you trying to obtain it before seeing me today?
Answer: Your insurance company may require a document known as a referral in order for us to see you. Without a referral from your Primary Care Provider (PCP) prior to your visit, we are unable to see you and bill your insurance company. If you are unable to get a referral from the required physician, you are financially responsible. In these situations we offer our private pay discount prices. We will offer you a copy of the charges so that you may submit them to your insurance company. Most insurance companies will provide these claim submission forms on the web, or they may be obtained from your human resource department.
Question: What is a Primary Care Provider (PCP)?
Answer: A PCP is a physician that you or your insurance company has selected to be your main provider of your routine health care. For an HMO type insurance plan, they may act as a gate keeper that directs your access to specialist care as needed.
Question: What if my PCP fails to send a referral?
Answer: You may choose to pay for your visit, go to the ER, or wait and see your PCP when they are able to see you.
Question: What is meant by the term "network provider"?
Answer: A network provider is a doctor, hospital, or other type of facility that provides testing or treatment and has a contract with your insurance company. The network provider agrees to offer services to you, at prices set by your insurance company, in return for steering patients to that provider. Network providers must follow the rules and policies of your insurance company. They are not allowed to waive co-pays, co-insurance or deductibles.
Question: Do you always see people in the order they arrived?
Answer: Not always, we use a triage process in order to save you time. Patients requiring immediate attention may be moved up.
Question: What will happen during the triage?
Answer: We may start tests and take x-ray in preparation of your visit with the Doctor; just like most hospitals we have standing orders. This allows for the most effective use of your time. This is a process commonly used in most emergency rooms.
Question: What happens after I am triaged?
Answer: You may be placed directly into a treatment room, or escorted to the lobby to await your test results. Once your results are available, you will be escorted to a treatment room. Additional tests may be ordered after your visit with the doctor. Treatments are given and you are discharged.
Question: I need to have a CT/MRI/or Ultra Sound, where can I have this done?
Answer: You may have these tests performed at any facility of your choice. You will need to indicate to us where you want to go. This decision may be influenced by your insurance company and your personal preferences. Your insurance company may only pay for some of your costs when you stay in network.
Question: How do you determine what I must pay at the end of my visit?
Answer: We may use secure insurance company websites, call centers or fax. When we are unable to verify your benefits, we may estimate your responsibility based upon our experience and the information you provide. When we are forced to estimate your cost, we apply all applicable discounts before we collect your co-pay or deductible.
Question: What is a deductible?
Answer: The deductible is the amount you must pay before your insurance will start to cover the cost of your health care.
Question: What is the co-pay?
Answer: This is the amount of money that your insurance company requires you to pay for an office visit. It is usually a set dollar amount. The co-pay usually only applies to the office visit. Any additional testing may be subject to your co-insurance or deductible.
Question: What is co-insurance?
Answer: This is the amount of money that your insurance company requires you to pay for every service provided. It is usually a percentage of the allowed charge amount. The co-insurance does not usually start until your deductible has been met.