Sometimes, people aren’t sure whether they should get treatment from an urgent care center or if they should head to an emergency room. While there is some debate, there are general guidelines revolving around which option to pick. The patients you see should have more minor conditions such as a fever or allergic reaction if they are in an urgent care center, while emergency rooms are for patients with more severe conditions like a stroke or heart attack. But not all cases are so easy to distinguish, so it can be hard to know if a patient is in the right place. Find out whether a patient is better off at an urgent care center or an emergency room.
What Patients Should Be in an Emergency Room?
To determine if your patients should be in an emergency room, there is one primary question that should be asked: is the patient’s condition life-threatening? If the answer is yes, then they have every reason to be in an emergency room. Patients will often go to an emergency room when they have symptoms such as repetitive vomiting, paralysis, shortness of breath, and internal bleeding.
What Patients Should Be in an Urgent Care Center?
Knowing what patients should be in an urgent care center isn’t always easy. However, generally speaking, if the patient’s condition doesn’t threaten their life, then they should be in an urgent care center. You should see people with conditions such as ear infections, animal bites, fevers, diarrhea, seasonal allergies, and bronchitis.
If you suspect that the patient’s condition is worsening, then you will want them moved to an emergency room so they can get the appropriate care.
Think About the Prudent Layperson Standard
There is one more significant factor that should be considered before choosing whether someone should be in an urgent care center or an emergency room. That factor is called the Prudent Layperson Standard (PLS).
Many insurance companies use the PLS as a gauge to determine if a patient truly needs to go to an emergency room for their treatment or if that would be unnecessary. Some patients get denied coverage from insurance companies because their symptoms weren’t severe enough.
There is a grey area, however. For borderline cases in which patients are experiencing symptoms that correlate with a severe medical condition, even if the final diagnosis determines it is less severe, the claim should still get covered.
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