It’s called an urgent care emergency center — but which is it? (2024)

One evening last December, Tieqiao Zhang felt severe stomach pain.

After it subsided later that night, he thought it might be food poisoning. When the pain returned the next morning, Zhang realized the source of his pain might not be as “simple as bad food.”

He didn’t want to wait for an appointment with his regular doctor, but he also wasn’t sure if the pain warranted emergency care, he said.

Zhang, 50, opted to visit Parkland Health’s Urgent Care Emergency Center, a clinic near his home in Dallas where he’d been treated in the past. It’s on the campus of Parkland, the city’s largest public hospital, which has a separate emergency room.

He believed the clinic was an urgent care center, he said.

A CAT scan revealed that Zhang had a kidney stone. A physician told him it would pass naturally within a few days, and Zhang was sent home with a prescription for painkillers, he said.

Five days later, Zhang’s stomach pain worsened. Worried and unable to get an immediate appointment with a urologist, Zhang once again visited the Urgent Care Emergency Center and again was advised to wait and see, he said.

Two weeks later, Zhang passed the kidney stone.

Then the bills came.

The patient: Tieqiao Zhang, 50, who is insured by BlueCross and BlueShield of Texas through his employer.

Medical services: Two diagnostic visits, including lab tests and CAT scans.

Service provider: Parkland Health & Hospital System. The hospital is part of the Dallas County Hospital District.

Total bills: The in-network hospital charged $19,543 for the two visits. BlueCross and BlueShield of Texas paid $13,070.96. Zhang owed $1,000 to Parkland — a $500 emergency room copay for each of his two visits.

What gives: Parkland’s Urgent Care Emergency Center is what’s called a freestanding emergency department.

The number of freestanding emergency rooms in the United States grew tenfold from 2001 to 2016, drawing attention for sending patients eye-popping bills. Most states allow them to operate, either by regulation or lack thereof. Some states, including Texas, have taken steps to regulate the centers, such as requiring posted notices identifying the facility as a freestanding emergency department.

Urgent care centers are a more familiar option for many patients. Research shows that, on average, urgent care visits can be about 10 times cheaper than a low-acuity — or less severe — visit to an ER.

But the difference between an urgent care clinic and a freestanding emergency room can be tough to discern.

Generally, to bill as an emergency department, facilities must meet specific requirements, such as maintaining certain staff, not refusing patients and remaining open around the clock.

The freestanding emergency department at Parkland is 40 yards away from its main emergency room and operates under the same license, according to Michael Malaise, the spokesperson for Parkland Health. It is closed nights and Sundays.

(Parkland’s president and chief executive officer, Frederick Cerise, is a member of KFF’s board of trustees. KFF Health News is an editorially independent program of KFF.)

The hospital is “very transparent” about the center’s status as an emergency room, Malaise told KFF Health News in a statement.

Malaise provided photographs of posted notices stating, “This facility is a freestanding emergency medical care facility,” and warning that patients would be charged emergency room fees and could also be charged a facility fee. He said the notices were posted in the exam rooms, lobby and halls at the time of Zhang’s visits.

Zhang’s health plan required a $500 emergency room copay for each of the two visits for his kidney stone.

When Zhang visited the center in 2021 for a different health issue, he was charged only $30, his plan’s copay for urgent care, he said. (A review of his insurance documents showed Parkland also used emergency department billing codes then. BCBS of Texas did not respond to questions about that visit.)

One reason, “I went to the urgent care instead of emergency room, although they are just next door, is the copayment,” he said.

The list of services that Parkland’s freestanding emergency room offers resembles that of urgent care centers — including, for some centers, diagnosing a kidney stone, said Ateev Mehrotra, a health care policy professor at Harvard Medical School.

Having choices leaves patients on their own to decipher not only the severity of their ailment, but also what type of facility they are visiting all while dealing with a health concern. Self-triage is “a very difficult thing,” Mehrotra said.

Zhang said he did not recall seeing posted notices identifying the center as a freestanding emergency department during his visits, nor did the front desk staff mention a $500 copay. Plus, he knew Parkland also had an emergency room, and that was not the building he visited, he said.

The name is “misleading,” Zhang said. “It’s like being tricked.”

Parkland opened the center in 2015 to reduce the number of patients in its main emergency room, which is the busiest in the country, Malaise said. He added that the Urgent Care Emergency Center, which is staffed with emergency room providers, is “an extension of our main emergency room and is clearly marked in multiple places as such.”

Malaise first told KFF Health News that the facility isn’t a freestanding ER, noting that it is located in a hospital building on the campus. Days later, he said the center is “held out to the public as a freestanding emergency medical care facility within the definition provided by Texas law.”

The Urgent Care Emergency Center name is intended to prevent first responders and others facing life-threatening emergencies from visiting the center rather than the main emergency room, Malaise said.

“If you have ideas for a better name, certainly you can send that along for us to consider,” he said.

Putting the term “urgent” in the clinic’s name while charging emergency room prices is “disingenuous,” said Benjamin Ukert, an assistant professor of health economics and policy at Texas A&M University.

When Ukert reviewed Zhang’s bills at the request of KFF Health News, he said his first reaction was, “Wow, I am glad that he only got charged $500; it could have been way worse” — for instance, if the facility had been out-of-network.

The resolution: Zhang said he paid $400 of the $1,000 he owes in total to avoid collections while he continues to dispute the amount.

Zhang said he first reached out to his insurer, thinking his bills were wrong, before he reached out to Parkland several times by phone and email. He said customer service representatives told him that, for billing purposes, Parkland doesn’t differentiate its Urgent Care Emergency Clinic from its emergency department.

BlueCross and BlueShield of Texas did not respond to KFF Health News when asked for comment.

Zhang said he also reached out to a county commissioner’s office in Dallas, which never responded, and to the Texas Department of Health, which said it doesn’t have jurisdiction over billing matters. He said staff for his state representative, Morgan Meyer, contacted the hospital on his behalf, but later told him the hospital would not change his bill.

As of mid-May, his balance stood at $600, or $300 for each visit.

The takeaway: Lawmakers in Texas and around the country have tried to increase price transparency at freestanding emergency rooms, including by requiring them to hand out disclosures about billing practices.

But experts said the burden still falls disproportionately on patients to navigate the growing menu of options for care.

It’s up to the patient to walk into the right building, said Mehrotra, the Harvard professor. It doesn’t help that most providers are opaque about their billing practices, he said.

Mehrotra said that some freestanding emergency departments in Texas use confusing names like “complete care,” which mask the facilities’ capabilities and billing structure.

Ukert said states could do more to untangle the confusion patients face at such centers, like banning the use of the term “urgent care” to describe facilities that bill like emergency departments.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Emmarie Huetteman of KFF Health News edited the digital story, and Taunya English of KFF Health News edited the audio story. NPR's Will Stone edited the audio and digital story.

Copyright 2024 KFF Health News

It’s called an urgent care emergency center — but which is it? (2024)


It’s called an urgent care emergency center — but which is it? ›

Urgent cares can have many different names: after-hours clinics, walk-in clinics, minute clinics, and minor emergency centers. The most accurate way to think about them is as standard medical clinics or offices, rather than emergency care centers.

What's the difference between emergency and urgent care? ›

Urgent care is for injuries or illnesses that are not life-threatening. The emergency room, on the other hand, is for serious issues that may be considered a medical emergency. One of the biggest differences between urgent care and the ER is the wait time and accessibility.

Which is more important urgent or emergency? ›

Unless a condition is life-threatening, a trip to urgent care is generally a better use of a patient's time and resources to treat injuries, fevers, infections and other ailments. Urgent care centers often have far shorter wait times than the ER and cost less than a traditional hospital emergency room visit.

What is the meaning of urgent care center? ›

An urgent care center is a walk-in clinic focused on the delivery of medical care for minor illnesses and injuries in an ambulatory medical facility outside of a traditional hospital-based or freestanding emergency department (ED).

What is the most urgent medical emergency? ›

Cardiac Arrest: This is when your heart suddenly stops. If not treated immediately the patient will die.

What are the limitations of urgent care? ›

Urgent care clinics are not equipped to handle life-threatening emergencies, such as heart attacks, strokes, or severe traumas. In these cases, immediate treatment provided at a hospital emergency room can be life-saving.

Should I go to urgent care or ER for arm pain? ›

The ER should be your first choice if an injury or illness appears severe or life-threatening. And if your condition isn't an emergency but you can't wait until the next day, that's when you should visit an urgent care center.

What to say to get seen faster in an emergency room? ›

Be specific: Describe your symptoms in detail. Instead of saying “I feel sick,” explain the specific symptoms you are experiencing, such as nausea, dizziness, or chest pain. This will help the medical staff understand the urgency of your situation. Use descriptive language: Paint a vivid picture of your symptoms.

What can be urgent but not important? ›

What Is an Example of Not Important but Urgent? An urgent but not important task might be responding to emails that don't concern you directly, posting to social media, or proofreading a colleague's report. These tasks need to get done, but they may not require your specific skill set.

What is the most common emergency visit? ›

Top Reasons People Visit the ER
  • Stomach and abdominal pain.
  • Chest pain.
  • Fever.
  • Cough.
  • Shortness of breath.
  • Headache.
  • Pain, unspecified site.
  • Back symptoms.

Is Urgent Care the same as a walk in Centre? ›

Walk-in centres, urgent care centres and minor injuries units give healthcare and advice. Most are open from early in the morning until late at night. You do not need an appointment, and you will be seen by an experienced nurse or GP.

Which is the most accurate definition of urgent care? ›

Urgent Care Medicine is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury. It requires a broad and comprehensive fund of knowledge to provide such care.

What does medically urgent mean? ›

A care need that isn't an emergency but requires prompt medical attention, usually within 24 to 48 hours. Examples include: Minor injuries and cuts. Sore throats and earaches. Frequent or severe coughs.

Why do people go to ER instead of urgent care? ›

If the injury or illness is life-threatening or could cause permanent disability, go to the ER. The emergency department is where you will get care for severe illnesses and injuries. If it's a life-threatening emergency, call 911 so first responders can provide care right away.

What is the best day to go to the ER? ›

The least busy times at the ER are usually early in the morning, particularly between 3 a.m. and 9 a.m. Weekdays, specifically Tuesday and Wednesday, tend to be less busy compared to weekends.

What symptoms will get you admitted to the hospital? ›

Don't put off going to the emergency room if you're experiencing:
  • Severe headaches or dizziness.
  • Pain in the chest or upper abdomen.
  • Lower abdominal pain.
  • Shortness of breath.
  • Uncontrolled bleeding.
  • Severe or persistent vomiting or diarrhea.
  • Severe allergic reactions.
Jan 11, 2022

What is the difference between an emergency appointment and an urgent appointment? ›

An emergency appointment is reserved for life-threatening conditions that require immediate attention, while an urgent appointment is for non-life-threatening conditions that still require prompt care but can wait for a short period of time.

What is a valid reason to go to the ER? ›

Serious burns or cuts that won't stop bleeding or close. Severe allergic reaction. Severe cold or flu symptoms. Shortness of breath. Stroke symptoms like slurred speech, numbness on one side, facial droop, or vision loss.

What is the difference between urgent and emergency surgery? ›

Urgent surgery is necessary for a serious condition that requires timely treatment but does not need to be performed immediately. Emergency surgery is required for life-threatening situations that demand immediate action to save life, limb, or functional capacity.


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