Denied Service at an urgent care

[Jnlaws730]

I know this doesn't constitute as medical malpractice, but I'm not sure if what happened was fair. Two days ago I went to an ED and was treated at the ED. The ED told me to be seen in two days for a follow up to the treatment of the wound. They told me I could go to any ED, my primary care, or place where they could unpack the wound. My copay for ED visits cost $150. After a talk with my insurance they notified me that I could go to an urgent care center and my copay would be $50 instead of another $150. They then gave me a list of urgent care centers to call and see if they could do the services before I went. I called he closest one to me, explained the situation and treatment I had done, and asked if they could unpack it. They then told me that they could unpack it and repack it if necessary, and I should bring my discharge information with me. Well, today they completely denied me services without even seeing the wound. Right at the front desk, someone walked up while I was talking to the receptionist and told me "we cannot do that here" I followed up saying someone told me yesterday that I could come and be treated here, she says "Well it depends on our comfort and we don't feel comfortable treating you. Go back to the ED where they did it", as she walked away. Now I have to pay another copay of $150, but I wanted to know if this practice is fair. Can someone just deny you services, without seeing what they would be dealing with, especially after they just told me they would do it?

 

[adjusterjack]

No, it's not malpractice.

Yes, you can be denied service.

The lesson: never rely on anything anybody tells you on the phone, especially if you don't write down the full name and position of the person you are talking to.

At any rate you can check with other urgent care locations to see who does what.

Better yet, find yourself an in-network primary care physician who you can see regularly with minimal co-pays.

 

[Jnlaws730]

No, it's not malpractice.

Yes, you can be denied service.

The lesson: never rely on anything anybody tells you on the phone, especially if you don't write down the full name and position of the person you are talking to.

At any rate you can check with other urgent care locations to see who does what.

Better yet, find yourself an in-network primary care physician who you can see regularly with minimal co-pays.

Thank you for your response. I dont understand how they can deny anyone services, so easily. Are there not laws against that? Its not like I said I didn't have insurance, they just walked right up and said no we don't feel comfortable and walked away. Also, I have an in network primary care, I called her to see if she had any appointments and she did not have anything available in two days.

 

[Jnlaws730]

No, it's not malpractice.

Yes, you can be denied service.

The lesson: never rely on anything anybody tells you on the phone, especially if you don't write down the full name and position of the person you are talking to.

At any rate you can check with other urgent care locations to see who does what.

Better yet, find yourself an in-network primary care physician who you can see regularly with minimal co-pays.

Nonetheless, thank you for your advice once again.

 

[cbg]

No, there are not any laws that force them to provide services for you unless it is an emergency situation. And when I say emergency I am not talking about follow up care (which is NOT an appropriate use of urgent care services); I am talking about life threatening.

 

[Jnlaws730]

No, there are not any laws that force them to provide services for you unless it is an emergency situation. And when I say emergency I am not talking about follow up care (which is NOT an appropriate use of urgent care services); I am talking about life threatening.

In your definition of emergency, then my follow up would not be appropriate to go back to an ED either, which my doctor referred. Urgent Care and ED seem to be one in the same, except an ED would actually be for more higher level care than an urgent care.

 

[cbg]

You asked if there weren't any laws that prohibited them from denying you services. The answer is, no, not unless it is an emergency situation where loss of life or limb is a possibility. In all other circumstances, there is no law that prohibits them from denying you services.

You and your doctor can fight out what's appropriate and what's not, but you asked about the law and that is what I answered.

 

[ElleMD]

Many urgent care facilities are only for initial triage, not continuing care or complex cases. If after arrival, it was determined that your needs fell outside the scope of what they provide, they do not have to provide treatment. It is not unusual to be referred elsewhere when your situation is not something they can adequately treat. I have had that happen myself; once after I had called first. Frankly, I would rather they not try to treat me if they are not properly equipped or trained to do so. Whether it is best to return to the hospital which initially treated you, or to try another facility or PCP who might be better able to provide care is your call. Public hospitals are obligated to provide at least minimal care to anyone who darkens their door. Private hospitals, doctors in private practice, and urgent care centers are not so obligated.