FAQs
Frequently asked questions
An emergency room (ER) treats illnesses and injuries that require immediate attention, such as chest pain, abdominal pain, dehydration or complex fractures.
Urgent care typically treats acute and chronic illnesses and non-life-threatening injuries, including common colds, flu, strep throat, lacerations and other minor conditions.
No. Virginia Mason Franciscan Health (VMFH) Emergency & Urgent Care is a fully licensed emergency room that offers a unique approach to billing. During urgent care hours (7 a.m.-9 p.m.), we may provide the benefit of courtesy urgent care billing if a medical provider feels urgent care services are appropriate. The final billing classification (emergency room vs. urgent care) is determined based on the resources utilized in your care. This ensures patients receive the appropriate level of care while potentially benefiting from reduced costs when urgent care services are sufficient. You will be informed of your billing class before you are discharged from the facility.
For urgent care services at VMFH Emergency & Urgent Care, being in network means we have a contract with your insurance company and have agreed on the cost of any service provided to you. Out of network means we do not have a contract with your insurance company, which may result in a different billing rate as determined by your insurance company and benefit plan.
Your insurance company negotiates rates on your behalf with providers such as VMFH Emergency & Urgent Care and agrees upon the rates they feel reflect the value provided to their members. Factors include provider quality, accessibility and the overall patient experience.
An Explanation of Benefits, or EOB, is something the insurance company sends to explain what is allowed by their policies and their associated charges. It is not a bill, but rather a communication from the insurance company to the patient. Your EOB may or may not directly match your final bill from VMFH Emergency & Urgent Care.
Visit our insurance and billing page for additional information.
All health care insurance, including Medicare, distinguishes between first-time visits and follow-ups in office or urgent care settings. The new patient charge is typically reimbursed at slightly higher rates than following visits to the same location due to the additional work required to set up new accounts and gather necessary details.
Established patients are those who have been seen at the same office or urgent care within the past three years. The charge for an established patient visit is typically less than the new patient charge.