On Your Side Investigation: Know this before your next urgent care visit

Published: Oct. 28, 2019 at 12:38 PM CDT
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A father's bill looks more like a mortgage payment. Two strep throat tests cost $1,000. That's after insurance. Fred Grimm spent months trying to understand why. That's when he reached out to On Your Side reporter Ashley Reynolds.

"Quite frankly for two kids in our family to have strep throat it should not be out of pocket equivalent to a mortgage payment," he said.

Grimm, now lives in Texas, but these bills followed him. Earlier this year, he took his kids to the urgent care inside the Turner Center connected to Cox South Hospital.

"We were expecting urgent care costs. We weren't there to be admitted to the hospital," Grimm said.

Thinking there might be a mistake, he called his insurance company. Grimm was told this is what he owes.

On Your Side reached out to CoxHealth. Instead of going on-camera, a spokesperson gave a statement.

It reads, "Urgent care services at the Turner Center are classified as hospital-based. This location has additional resources that traditional urgent cares do not."

A few weeks later, On Your Side went to a new urgent care ribbon cutting in Springfield to get answers. Amanda Hedgpeth, the Vice President of Clinical Services for CoxHealth says there's a facility fee at the Turner Center.

"We have signage whenever you walk into Turner Center Urgent Care both on the pediatric side and the adult side. Letting you know you may receive different bills," Hedgpeth said.

"It certainly wasn't in bold face or predominantly displayed everywhere that it was outpatient," Grimm said.

The sign reads - Cox Urgent Care is a hospital based facility, and you will receive two bills: one from Cox Urgent Care Facility and one from Cox Urgent Care Physicians.

"Much of it depends on how your own insurance company processes those claims and what your individual co-pay structure is. We encourage patients to really understand their own insurance benefits and look for signage anytime you walk in any location," said Hedgpeth.

Location matters, make sure you understand how that facility bills before you receive services. If you don't think your bill is accurate or fair, take action. Call the provider and your insurance. Ask for it to be reviewed. Also ask for a patient advocate so you can understand your options.