Three weeks ago, a WSB Forums member started a discussion there about a $100 fee charged by Highline Medical’s West Seattle Urgent-Care Clinic that was not covered by her insurance. Among discussion participants, much discussion and research followed. The thread was called to our attention, and we sought a response from Highline, as the questions continued to pile up. Today, we have that response from Highline Medical Group’s administrator, confirming that this is a fee charged “for the higher costs of operating an urgent care facility during weekends and evening hours, when there is irregular demand for services,” and saying they are working to get more insurance companies to cover it – with another group coming on board next month, Regence. (Highline is not the only health-care organization with an urgent-care charge, according to one post in the discussion.) Read on for the statement:
As the Administrator of Highline Medical Group, I’d like to answer the questions raised by patients about billing for urgent care services. We do charge a $100 urgent care fee – which is a legal billing code and is covered by some insurance companies. This fee partially compensates us for the higher costs of operating an urgent care facility during weekends and evening hours, when there is irregular demand for services. Our staff and facility are here waiting for you, even when you might not need us.
Like many other healthcare services, the urgent care charge is covered by some insurance carriers and not by others. We have been working with insurance plans to get this fee covered for our patients. If you have the following insurance, you will not be billed personally for the fee:
• First Choice Network PPO
• Regence (effective 4-1-12)
• HMG Medicare Advantage Plans (United/Secure Horizons, Humana, Molina)
• HMG Managed Medicaid (CUP)
• Medicare
• MedicaidWe are still negotiating with other insurance carriers and will update the West Seattle Blog community as we add them.
We do our best to explain to patients that there is an extra fee accompanying treatment at an urgent care clinic. We emphasize that a patient’s insurance company will be billed and it may (or may not) cover the full cost. If the insurance company does not pay, that fee becomes the patient’s responsibility. We ask patients to sign a form acknowledging this because we don’t want them to be surprised by a bill they weren’t expecting. For those who object to the fee, we can offer regularly scheduled appointments during office hours at West Seattle Family Medicine, with no urgent care fee. We are always happy to work with any patient for whom the $100 charge represents financial hardship. Patients can contact us directly at 206.242.8300 if they have questions or would like assistance.
We are sorry there has been so much confusion about this. We take all community input very seriously. Based upon the feedback we have received from the community, we are developing new printed materials that explain the charges in detail and we are working with our staff to assure that they are explaining the charges more thoroughly to each patient.
We are committed to the West Seattle community. I want to assure you that we are doing our best to balance the needs of the community for extended hours with the cost of providing the care.
Susan Pursell
HMG Administrator
Highline opened its Urgent Care clinic in West Seattle last fall east of Jefferson Square, and plans to move later this year to a new location in The Triangle (currently home to Cycle U, which is in turn moving to Harbor Avenue next month).
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