Urgent Care Costs & Prices in NY

Costs & Fees At Urgent Care – Avoiding A Sticker Shock!

There was a time we had to encourage folks NOT to use an Emergency Room for minor emergencies (read our blog urgent care vs. emergency room) as the average ER bill is upwards of $1000. Now, that there are 10,000+ Urgent Care Centers in the US – far more than the number of Emergency Rooms, it is time to discuss how to avoid making financial mistakes in choosing an Urgent Care whether you need a service, a lab or a vaccination. (Statcare’s prices are listed below). Being a smart consumer of healthcare services can be challenging indeed. These tips will help you save a bundle in the long run, esp. in NYC Area. Statcare has been in business 10 years- we know what we are talking about (check out our reviews). Healthcare need not cost you so much. Visit our locations in Queens, Brooklyn, Bronx & Hicksville, Long Island.

Mistake #1.
Going to a “Big Chain” Urgent Care (20 or more locations)

Do that and chances are you’ll have to cough up a pretty penny!

Why?
The negotiated rate of Big Chain Urgent Care (20 or more locations) is often upwards of 3 times that of smaller urgent care centers.

You might think, “I have health insurance, why should it matter at all? My insurance will foot the bill”. Well, you are in for a $300+ sticker shock. You forgot that deductible!!

As of 2019, there are hardly any health insurance plans that have a zero deductible amount. A deductible is the portion you pay for covered health care services before your health insurer starts to pay.

Here is a real case scenario from a Big Chain Urgent Care in NYC.
You have Big Blue Insurance
You have a $5,000 deductible
You have a $50 co-pay.

(This means you are required to pay the first $5,000 of all covered services before your Insurer even becomes liable for any costs).

Here is how this will work:
You visit the Big Chain Urgent Care.
They will collect just your $50 copay at the time of the visit.
You go home after your visit.
The Big Chain Urgent Care now submits a bill for $350+ to your insurance plan because that is what their contract with Big Blue Insurance Company states. (The same Big Blue Insurance Company had contracted rates of $100 with other urgent care centers in your neighborhood – you just had no way of knowing that, of course).

Your Insurer approves all their charges as per their negotiated fee arrangement with the Big Chain Urgent Care.
The amount of $350+ becomes payable to Big Chain Urgent Care.
But your insurer knows you have a deductible.
So, it applies the $350 amount towards that deductible.

You already paid $50 as a copay when you had your visit.
The Big Chain Urgent Care is told that $300 ($350 charge minus the $ 50 copay) is the members responsibility as the deductible has not been met. That member is you.
And that “big fat bill” from the Big Chain Urgent Care is now coming to you!
Guess what?
You, now have to cough up another $300. All because there is no transparency in health care. It is rigged to benefit Big Chain Urgent Care. It is geared towards sick care, not health care. That Big Chain Urgent Care will now want you to see the hospital doctors and specialists who are “all in” on this.

In fact, three of the “Big Chain” Urgent Care Centers in NYC have a negotiated rate of $300+ with many insurers and upwards of $200 with almost all other insurers. Had you chosen to go to a different Urgent Care, your out-of-pocket expense would have barely touched $100 in total – you could have paid all of it in person and be done. Statcare believes in simplicity. Transparency. How urgent care ought to be.

Lesson# 1. The only thing that matters when you choose an Urgent Care in today’s world is your deductible. If you have a deductible, go to a smaller UCAOA Accredited Urgent Care.

What can you do to reduce your urgent care cost and fees?

It can be a harrowing experience for sure. The worst thing is not knowing what one’s financial liability will be. Many customers using these Big Chain Urgent Care Centers are stuck with bills of several hundred dollars. Followed by calls from their “network doctors” to enroll in their next version of care. Specialists. Primary Care. Radiology for Imaging. Procedures where Orthopedics, Anesthesia and other out-of-network specialists can bill preposterous amounts. They will send you to the hospital supported labs for blood tests or may refuse to do ANY blood tests at their facility because they want you to go somewhere else. The more you circulate within their network, the more opportunities they have to generate billable services. So, what can you do to negotiate a flawed system like this?

First and foremost, find out your potential financial liability before you go to that Big Chain Urgent Care Center by calling your health plan and asking them the contracted charges. Remember, these Big Chain Urgent Care Centers are now the ‘new’ and ‘overpriced’ Emergency Rooms of yesterday. And they are giving all urgent care a bad name.

Secondly, call around the urgent care centers in your area and ask about their pricing. Many staff at these facilities may not be able to answer all your questions especially as they will not know what your potential treatment will be. Their pricing will give you some idea, at least.

Thirdly, visit their website. Look for price transparency in costs-fees and service charges.

At Statcare, we have transparent pricing as listed on our website if you are paying for your care. With high deductibles, at Statcare you can pay for your care so you never have to worry about another bill. That is simplicity in a broken system. Equal access that you can count on. After care services, online doctor visits and multiple ways to communicate with our staff including online access to your chart. Same coordinated care at a lower cost. Statcare is a one stop shop for all your family’s health care needs. For 10 years, we have been disrupting the status quo, providing holistic care and keeping our communities happy, healthy and productive. Five convenient locations in NYC area.

Mistake #2.
Not knowing your co-pay for an urgent care visit before you go to the Urgent Care.

If you are young and healthy, chances are you have never had to use your health insurance plan. It is very common for people to not know what their copay is for an urgent care visit. As a result, you may not have carried with you enough money or have the credit card to charge the copay. Not to worry.

What can you do to find out your copay cost?

Here is how you can find out your copay information

1. The copay is usually listed on the health insurance card. The ER copay is usually the highest ($100-500 or more), the Urgent Care copay is usually in the $40-75 range and the PCP copay is usually in the $25-40 range
2. Sometimes you will not find an urgent care copay. However, there will be a specialist copay listed. Urgent Care copays are usually the same as a specialist copay.
3. You can call your health plan and find out your copay.
4. You can walk into a Statcare facility and our staff can swipe the insurance card and let you know what your benefit plan coverage and copay are before you decide how you want to proceed.

Lesson # 2. Know your urgent care copay. If you have a high copay, you might want to consider other options. Going to a primary care physician or negotiating an all-inclusive price for your visit will avoid having to deal with unnecessary bills.

Mistake # 3.
Going to a hospital based Urgent Care believing it will be a low cost, low-priced visit

Many hospitals have opened their own Urgent Care or affiliated themselves with one. This is to keep their footprint in the communities where customers live and work. Hospitals call customers with insurance “covered lives” and capturing every covered life in their territory is the basis for their profitability and their negotiating power with insurance plans, Medicare and Medicaid. Getting insured patients through primary care physicians (PCP’s) is no longer a viable option as 70% of millennials don’t have PCP’s and don’t want to be captive lives in a network. So they have turned to Urgent Care to ensure they keep enrolling covered lives and help maintain a constant flow of labs, tests, radiology imaging, specialist referrals and procedures to their hospital affiliated network. This kind of an urgent care visit has the potential to be an expensive option. If you have a cut or an injury, they are more likely to refer you to an Orthopedic or a hand surgeon rather than do the stitches themselves. They would rather you go to their other office for getting blood tests done. Or visit their community based radiology imaging facilities for a CT Scan or an MRI. Big Chain urgent care are about sick care. Not health care. Visits to such Big Chain urgent care usually carries with it the risk of quickly becoming a high cost, high fees visit for other reasons too.
Why?
These urgent care clinics (esp. if they are near hospital ER’s) are merely hospital emergency rooms disguised as urgent care. They probably will bill like an Emergency Room (not your low cost, low fees facility for sure!).

Also, their contracted billing rates for urgent care visits are upwards of $300 in the NYC area as discussed baove. Even if it is merely a visit for a Strep. test or UTI or a Flu test. You would think your insurance company would have been smarter. Well, they are. Insurance companies happily pay that $300+ rate because when they sat down to negotiate contracts, they sought for deeper discounts on the “hospital billing side” as compared to the “ambulatory care visits”. Hospitals call it “leverage” and then quickly used it to open multiple affiliated urgent care in every community, all the way into long island! As a consumer having deductibles in your health plan, that Big Chain leverage translates into monstrous costs for you as an end-consumer. It therefore makes absolute sense for you to seek a lower and if possible fixed amount for your medical care. At Statcare, for 10 years, we have provided customers with that alternative by being transparent with our pricing. By keeping it simple, easy and reasonable. The way health care should be.

What can you do to find out the costs and fees for your visit?

Here are some options:

1. Ask before you get seen, if that facility bills as an urgent care or as an ER. Write down the name of the employee that gives you that information. When you receive an ER bill for that visit, you will be able to go back to the billing office and negotiate better because you will have the name of the employee that misinformed you in the first place.
2. Avoid BIG CHAIN urgent care completely and go to a urgent care with less than 20 locations. Most likely your bills will be half of what a Big Chain Urgent Care would charge and collect from you.

Lesson # 3. Know where you go. What’s in a name? Everything! When it comes to ER or Urgent Care, a hospital name suggesting charity may not be so charitable after all!

Mistake # 4.
Not considering a Televisit

If you are in a bind, there are far more economical options than going to a Big Chain Urgent Care.

A typical Urgent Care visit may cost you around $100. A televisit costs far less.

How do you cut your costs and fees for medical services with a Televisit?

The world of Televisists can be confusing. You want to use a Televisit option with a physical office as a back-up, just in case you need blood tests or X-Rays or someone to check you out in person.

Statcare has an office near you in case you needed to be seen as well.

When you call Statcare, you can be serviced through a Televisit from the comfort of your home. You do not need anything except your smartphone or iPad or computer and a decent wifi signal.

If you haven’t tried a Televisit, you must! It can be scheduled between your meetings or at your lunch break or even late at night when most urgent care centers are closed. The prescriptions from a Televisit will be sent electronically to a pharmacy near you. Insurance covers these visits and if you are paying for it yourself, these visits aren’t expensive. Check out Statcare’s prices listed below.

What Cost Transparency Or Fee Transparency Means At Statcare

“Providing accurate and relevant prices including what is covered or not covered in that price”.

The last thing we want is for our customers to have crushing debt from hidden or unexpected medical expenses. Statcare is a leader, not just in price transparency but also in providing comprehensive healthcare that’s affordable and accessible to everyone

It is a myth that higher price always means a better quality of healthcare.

Going to a UCAOA certified Urgent Care definitely means a higher quality of care.

At Statcare, we try to be transparent with pricing and payment policies.

You can always call us and we will be glad to answer any questions you have.

As a part of our commitment to transparency, we have posted the prices for many of our services below. While this list is by no means all-inclusive of all the services that Statcare offers, it does provide the cost and fee information for many of frequently provided services.

If you plan on using insurance, we recommend you call your insurance company before your visit to make sure that the service you want from Statcare is covered under your plan.

Participation in Statcare’s self-pay pricing cannot be combined with the use of commercial insurance benefits. Statcare’s self-pay pricing cannot be provided to patients participating in any Government Health Plans.

Prices shown below reflect discounts that patients without insurance are eligible for only if they pay in full at the time of receiving medical care. All prices are estimates and can change over time. The website may not reflect the most updated current or recent pricing esp. for vaccines and equipment based procedures as market forces determine the procurement costs. To receive actual pricing, patients who do not have health insurance may request prices by calling our number listed above. All prices are provided before the visit. However, please note, the cost may increase if there is a medical procedure being done and additional treatments are needed. A good example is wound care where a cautery may be needed to stop bleeding before the wound can be stitched up. At Statcare, we are committed to keeping you informed about your costs at all times.