Kaweah Delta negotiates new urgent care billing deal

Anthem Blue Cross was overcharging Kaweah Delta patients’ urgent care visits as emergency department visits

The Sun-Gazette

VISALIA – Kaweah Delta has negotiated a new arrangement with Anthem Blue Cross that will alleviate billing frustrations for its urgent care patients.

The agreement, which took effect on Nov. 1, means that people who have Anthem Blue Cross through independent policies or through employers such as school districts, cities, the County of Tulare, among others, can visit Kaweah Delta’s urgent dare centers, expect to pay their typical co-pay amount (for an urgent care visit), and receive a bill that is reflective of being seen at any freestanding urgent care center.

“We heard our community’s frustration with this contract loud and clear. We listened and have come up with a solution that we know those covered by Anthem Blue Cross will be happy with, especially as we enter cold and flu season,” said Gary Herbst, chief executive officer of Kaweah Delta.

Herbst said Anthem Blue Cross treated the urgent care centers, located on Court Street and at Demaree and Flagstaff, as if they were an extension of Kaweah Delta’s emergency department, rather than as urgent care centers. This left patients of Anthem Blue Cross with bills that were reflective of having received emergency care rather than urgent care services.

“We know that we can do everything beautifully from the moment a patient comes to us for care, but if we don’t provide a bill in an understandable, accurate and friendly manner, it can ruin a person’s entire experience. We heard our community’s frustration with this contract loud and clear,” Herbst said.

The Kaweah Delta clinics and urgent care centers (other than Kaweah Delta Medical Foundation) do operate on the Hospital’s license and, as such, they are subject to higher standards of construction, are required to be staffed differently, and are surveyed and certified by The Joint Commission, an accrediting body for healthcare organizations. As such, they cost a lot more to build and operate than independent, freestanding clinics and urgent care centers. 

“While this new arrangement with Anthem Blue Cross will reduce our urgent care center revenue, Kaweah Delta is committed to making healthcare affordable and available to all patients, so this was the right decision to make,” Herbst said.

Kaweah Delta Urgent Care Centers are open seven-days-a-week to care for patients when their doctor is unavailable. Care is available for everything from cold/flu to broken bones, cuts, burns and more. Kaweah Delta Urgent Care Centers offer labs and radiology services, but do not offer ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET). Patients can also check wait times online at www.kaweahdelta.org and get in line, online, to avoid sitting in the waiting room.

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