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Should I go to the Emergency Room, Urgent Care, or See My Primary Care Provider?

Choose the Right Care in the Right Setting to Save on Healthcare Costs

 |  For Patients

You had a pretty rough fall and are having trouble putting weight on your right ankle. You are experiencing flu-like symptoms. You have a concerning mole that recently changed shape. Each of these scenarios warrant concern, but how do you decipher when you need to go to the emergency department from when you just need to schedule an appointment with your doctor? This can be complicated to navigate, which is why we’re here to help.

We’ve provided your options for medical care and listed a few examples within each option to help you determine the best place to get care the next time you are experiencing a medical issue. We’ve also highlighted care options that are available to you when your primary care doctor can’t see you soon enough. The right decision can save money and ensure you’re only spending time in the emergency room when you absolutely need to.

Emergency Department

The emergency department is going to be your most expensive option for medical care, but there are times when this level of care is absolutely necessary. Any time you are experiencing life-threatening conditions, you need to call 911 or go to the closest emergency room. ACN patients have access to the emergency departments at Dignity Health, Abrazo Health, and Phoenix Children’s Hospital.

According to the American College of Emergency Physicians, examples of life-threatening emergencies include:

  • Bleeding that will not stop
  • Breathing problems (difficulty breathing, shortness of breath)
  • Change in mental status (unusual behavior, confusion)
  • Chest pain
  • Coughing up or vomiting blood
  • Fainting or loss of consciousness
  • Feelings of harming yourself or others
  • Head or spine injury
  • Severe or persistent vomiting
  • Sudden injury due to a motor vehicle accident, burns or smoke inhalation, near drowning experience, or a deep or large wound
  • Sudden, severe pain anywhere in the body
  • Sudden dizziness, weakness, or change in vision
  • Swallowing a poisonous substance
  • Severe abdominal pain or pressure

If you experience any of the symptoms above, call 911 or get to your nearest emergency department. No appointment is needed, and they are always open. You should always schedule a follow up appointment with your primary care provider after you have been seen for an emergency.

Urgent Care

Oftentimes people go to the emergency department instead of urgent care because they think it’s the fastest way to see a doctor. Choosing urgent care when appropriate will save you money and you’ll be seen by a doctor quickly.

Consider going to urgent care when you have an injury or illness that needs same-day care but is not life-threatening. General, non-life threatening conditions for both children and adults include:

  • Sprains
  • Strains
  • Fevers
  • Severe colds/flu
  • Rash or skin irritations
  • Mild asthma
  • Broken bones
  • Outpatient x-ray and lab services
  • Non-facial lacerations

If you experience any of the medical issues listed above, choose urgent care. You will save money by choosing an urgent care provider in your insurance network. Arizona Care Network members can always find their closest in-network urgent care on our website, then click on ‘Find a Facility.’ You can also download and print our Urgent Care map to keep handy in case you need to find a facility near you.

Urgent care facility hours will vary by location, but they are often open evenings, weekends, and holidays. No appointment is needed but some allow you to register and/or reserve a time online. If you think you’ll need lab or imaging services, call the location ahead of time to ask if they have these services on-site.

Telemedicine

Telemedicine allows you to see a doctor online to treat common conditions. Most health plans have a virtual care option, but look at your health insurance benefits to find out if this is an option for you.

You can consider the telemedicine option when you are experiencing common conditions like:

  • Allergies
  • Bronchitis
  • Pink eye
  • Upper respiratory infections
  • Urinary tract infections (UTI)
  • Low back pain
  • Ear infections
  • Rashes
  • Diabetes
  • High blood pressure
  • Mental illness/ behavioral health

You can use your Telemedicine service over the phone, web, or mobile app. Appointments are not required, but it is always recommended to follow up with your primary care provider.

Primary Care

Your primary care provider is the least expensive option for medical care. They are there to help you manage your preventive and general care and can coordinate other care that you may need. They know your health history and goals and can work with you to help you stay healthy.

You would want to schedule an appointment with your primary care provider if you need:

  • Annual wellness visit
  • Chronic disease management
  • Annual physical
  • Discuss any new health concerns that are not urgent or life-threatening
  • Routine screenings
  • Feeling anxious or depressed
  • You need a referral to a specialist
  • A follow up appointment after being in the emergency room or urgent care

An appointment is typically required, and hours will vary by practice. If you are a member of Arizona Care Network, you can find and establish care with a primary care provider near you using our Find a Provider tool.

Still Not Sure Where to Go?

Members of Arizona Care Network are always welcome to call ACN’s concierge line at 602.406.7226 in non-emergency situations to know your options for care.  We would love to help you find the right care setting and answer any questions you may have about your health insurance benefits. Receiving the right care in the right setting will help you save on healthcare costs and ensure you are receiving the best possible care at the same time.

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