Does Caprock ER take all insurance?

10,226 Views | 57 Replies | Last: 7 yr ago by akaggie
Ornlu
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lck04 said:

I took my son there when he sliced his ear open on a Sunday night at about 8pm. In and out in less than 30 minutes including all paperwork. It was clean, friendly, fast, and professional.

It would have cost me the same at the other ERs, this one was just much faster (Sunday night with a 4yo, fast is great).

Any injury I need immediate care for I'd go there first. The staff was great with billing and my insurance didn't have any trouble with it. Insurance is through Cigna.

I'm very glad I had that option instead of a crowded ER where a bloody ear wouldn't be a priority and I'd have been there for hours.
HAHAHAHA, You haven't gotten the bill yet have you? Please post back when you do. I'd bet that those stitches are going to run you $2500+ for "less than 30 minutes".

These detached ER's are to real hospitals what payday loan stores are to real banks.
csnole
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Our family has used CapRock twice this year and both times received excellent care from some of the best Drs and nurses in this town. We are fortunate to have choices in BCS when you feel you need emergency care - as for our last bill without going into detail it was $443 after insurance.
aggmaroon
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Caprock is not in network for BCBS at TAMUS. However, if it is a real emergency, BCBS would pay the same as they would any facility. The reason being that in an emergency situation you just need to get to an ER.

If it is not an emergency, for example, a cold or sore throat, you will pay out of network prices. That would be unfortunate when it would just be a co-pay at Brazos Valley Urgent Care.

There was an article in the TAMUS benefits newsletter last month about urgent versus emergency.

http://assets.system.tamus.edu/files/benefits/pdf/publications/newsletter/2016/BB-1016-Oct2016.pdf
unmade bed
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These type places are going to be popping up everywhere and they are IMO any way one of the primary drivers for the increase in insurance premiums.

You think your $600 ER copay sucks, how do you think your insurance Co feels about shelling out $2500 so you could get a couple of pain pills?

I don't necessarily blame the doctors that are going to this business model because it is much better for them than fighting with insurance companies for office visit reimbursement and having an entire staff of employees just to resubmit insurance claims.
lck04
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Ornlu said:

lck04 said:

I took my son there when he sliced his ear open on a Sunday night at about 8pm. In and out in less than 30 minutes including all paperwork. It was clean, friendly, fast, and professional.

It would have cost me the same at the other ERs, this one was just much faster (Sunday night with a 4yo, fast is great).

Any injury I need immediate care for I'd go there first. The staff was great with billing and my insurance didn't have any trouble with it. Insurance is through Cigna.

I'm very glad I had that option instead of a crowded ER where a bloody ear wouldn't be a priority and I'd have been there for hours.
HAHAHAHA, You haven't gotten the bill yet have you? Please post back when you do. I'd bet that those stitches are going to run you $2500+ for "less than 30 minutes".

These detached ER's are to real hospitals what payday loan stores are to real banks.


I did get the bill and it wasn't $2500 or even close.

I want to say it was in the $150 range after insurance which I was more than happy to pay.
Gasbandit
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Blue Cross/Blue Shield has told me they "accept" BCBS insurance but are not in-network, so higher deductibles and whatnot would apply.
akaggie
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befitter said:

If you need a real ER then go to a real ER attached to an actual hospital that can actually admit you if necessary. Otherwise all you need is an Urgent Care. These free standing ER's are a total rip off and they are abusing the health care system in my opinion.

Not necessarily. My daughter was complaining of a headache in January and it got progressively worse, to the point where she couldn't even open her eye because it was swollen shut and was screaming in pain. (She was 10.) I took her to the ER at The Med at Midnight and the ER doctor there took one look at her and said "it's a migraine' and ordered up the migraine protocol. I questioned him because I've never seen a migraine make an eye swell shut and she had no history of migraines. However, she did have a history of severe sinus infections. I asked him to run a CBC and a CT and he ROLLED HIS EYES AT ME. I was flabbergasted that he had the nerve to roll his eyes at the parent of a child in his ER. I explained her history of sinus infections and asked again that he run a CBC to at least tell us if she had an infection and if so, then I wanted a CT scan to see if it was a sinus infection so we could get started on antibiotics. He then informed me that antibiotics were not used to treat sinus infections. Mind you, I have worked with clinical pharmacists for eleven years and knew that was not the case. He just wanted us out of his ER so they could keep their wait times low for their billboards. The nurse came in and started a line on her to administer the migraine protocol and missed her vein four times. The migraine drugs knocked her out and he said, "See, I told you it was a migraine." I said I was not convinced because basically he just drugged her up to diminish the pain, he didn't identify the cause of the pain. We were discharged and went home. Three hours later, the migraine cocktail wore off and she was crawled into my room on her hands and knees begging me to call a helicopter to take her to a hospital. I called Caprock to see if they had a CT and they said yes, so I took her over to Caprock. The immediately took one look at her, ran a CBC, did a CT scan, and also checked the pressure in her eye, which was high. Long story short, she was transferred by ambulance to Texas Children's in Houston for emergency surgery for orbital cellulitis. (Google pics if you dare and then ask yourself how the ER dr at the Med could have thought that presentation was a migraine.) Her surgery at Texas Children's took THREE hours and I was told that had it been allowed to fester for another 48 hours, the outcome would not have been positive. The infection was so close to her brain tissue that they had to do a brain MRI the day after surgery to confirm that it had not penetrated her brain. She ended up spending a week at Texas Children's.

I'll take Caprock over a hospital ER any day. They listened and they saved her sight.
dubi
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Your problem was going to the Med....
KidDoc
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akaggie said:

befitter said:

If you need a real ER then go to a real ER attached to an actual hospital that can actually admit you if necessary. Otherwise all you need is an Urgent Care. These free standing ER's are a total rip off and they are abusing the health care system in my opinion.

Not necessarily. My daughter was complaining of a headache in January and it got progressively worse, to the point where she couldn't even open her eye because it was swollen shut and was screaming in pain. (She was 10.) I took her to the ER at The Med at Midnight and the ER doctor there took one look at her and said "it's a migraine' and ordered up the migraine protocol. I questioned him because I've never seen a migraine make an eye swell shut and she had no history of migraines. However, she did have a history of severe sinus infections. I asked him to run a CBC and a CT and he ROLLED HIS EYES AT ME. I was flabbergasted that he had the nerve to roll his eyes at the parent of a child in his ER. I explained her history of sinus infections and asked again that he run a CBC to at least tell us if she had an infection and if so, then I wanted a CT scan to see if it was a sinus infection so we could get started on antibiotics. He then informed me that antibiotics were not used to treat sinus infections. Mind you, I have worked with clinical pharmacists for eleven years and knew that was not the case. He just wanted us out of his ER so they could keep their wait times low for their billboards. The nurse came in and started a line on her to administer the migraine protocol and missed her vein four times. The migraine drugs knocked her out and he said, "See, I told you it was a migraine." I said I was not convinced because basically he just drugged her up to diminish the pain, he didn't identify the cause of the pain. We were discharged and went home. Three hours later, the migraine cocktail wore off and she was crawled into my room on her hands and knees begging me to call a helicopter to take her to a hospital. I called Caprock to see if they had a CT and they said yes, so I took her over to Caprock. The immediately took one look at her, ran a CBC, did a CT scan, and also checked the pressure in her eye, which was high. Long story short, she was transferred by ambulance to Texas Children's in Houston for emergency surgery for orbital cellulitis. (Google pics if you dare and then ask yourself how the ER dr at the Med could have thought that presentation was a migraine.) Her surgery at Texas Children's took THREE hours and I was told that had it been allowed to fester for another 48 hours, the outcome would not have been positive. The infection was so close to her brain tissue that they had to do a brain MRI the day after surgery to confirm that it had not penetrated her brain. She ended up spending a week at Texas Children's.

I'll take Caprock over a hospital ER any day. They listened and they saved her sight.
Your story has nothing to do with free standing vs hospital er, it was just a story about a bad er doc which can happen at either kind of er. The caprock docs are great I don't see anyone saying they are bad docs but it is a business model designed to maximize income for minor emergencies. Orbital cellultiis is not a minor emergency of course and even if you had gone to St Jo or BSW they would have had yo transfer you out for surgery and infectious disease consult. I'm assuming you were seen at TCH ER as well not admitted directly? That is the issue with non affiliated ERs they usually have you transfer from ER to ER causing two seperate ER bills and work. If you had gone to S&W it is likely they could have transferred you to Temple to be admitted and avoid double ER charges.

I'm a St Jo pedi so not promoting S&W or anything just trying yo explain the issues with the system. Hopefully St Jo will have an arrangement with TCH in the near future since we are now affiliated with them through CHI.

Hope your daughter is better that is a horrible infection that we worry about every dumb pink eye case!
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cslifer
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"Non affiliated ERs" transfer to other ERs? Have you as a St. Joesph doc looked at how many patients from St. Joseph College Station ER end up being transferred to the ER in Bryan? How does that compare to the "non affiliated ERs"? I can answer for you, waaaaaay more from St Joes College Station end up there. Most of the "non affiliated ERs" actually direct admit. So far as the connection between TCH and CHI, I must have missed the news, besides St. Luke's and TCH sharing a basement, what is the connection between TCH and CHI? I can't imagine TCH and St. Joseph in Bryan having more than a extremely minor connection....please fill me in.
Edit: auto correct spelling is horrible
Edit: as a pediatrician you know as well as I do that TCH takes almost everything through the ER, they do very few direct admits
AggiePhil
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By and large, transfers from the South CS ER get admitted directly into the main hospital, not the main ER. The SCSER is effectively an extension of the main ER (albeit with some limitations).
cslifer
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I would review the numbers, many more go to the Bryan Er than you think.
AggiePhil
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Hmmm, interesting. I could certainly be wrong but that's been my understanding and my personal experience. I'll seek clarification next time I see one of the docs.
KidDoc
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cslifer said:

I would review the numbers, many more go to the Bryan Er than you think.
The St Jo South ER direct admits to the floor or CCU, not ER to ER (in my experience with patients and family).

CHI is the parent company for St Lukes in Houston and through Lukes with TCH in Houston,and St Josephs and merged a bit over a year ago. So we are part of the same medical group at this point. Currently TCH Neo team is the Neo team for St Jo's in Bryan and there are hopes & plans for a tighter relationship in the future just nothing concrete at the moment. All of those big things move glacially slow.

Here is a link to the Catholic Health Initiatives locations in Texas at this time.

http://www.catholichealthinitiatives.org/landing.cfm?id=39758&action=list
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originaltexan
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OK,

In a sentence, if someone needs stitches, and has good insurance, where to go?

In a sentence, if someone needs something simple removed from eye and has good insurance, where to go?


The thread has many stories, but in a nutshell, I don't want to pay $3000 if i cut my foot on a shard of glass and need stitches.

At the same time, i don't want to go to a hospitals with a cut foot and the dr says take an aspirin and go to sleep.
AggiePhil
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I think if it's a true emergency that warrants ER capabilities, you should pay the same going to Caprock or to one of the hospital ERs. If it's more of a minor emergency/urgent care type thing, you're probably better served waiting it out or going to a hospital ER. Preferably the former.
KidDoc
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originaltexan said:

OK,

In a sentence, if someone needs stitches, and has good insurance, where to go?

In a sentence, if someone needs something simple removed from eye and has good insurance, where to go?


The thread has many stories, but in a nutshell, I don't want to pay $3000 if i cut my foot on a shard of glass and need stitches.

At the same time, i don't want to go to a hospitals with a cut foot and the dr says take an aspirin and go to sleep.
Great questions here. For stitches I would go to an Urgent/Express care not an ER. If all the express care locations are closed then an in-network ER would work it doesn't matter if it is free standing or attached. Same for the FB in the eye unless you could get in a same day with optometry or ophthalmology.
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Gasbandit
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When I got cellulitis in my leg, the St Joseph express care (not an emergency room) across Villa Maria from the hospital got me fixed right up with practically no wait time, and was in-network for Blue Cross/Blue Shield.
Scoopen Skwert
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Basic question is I'm having an emergency but I want to save money.
dubi
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bh93 said:

Basic question is I'm having an emergency but I want to save money.
Don't go to Caprock. SW or St Joe.

My advice is based on TAMU BCBS insurance.
akaggie
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Actually, she was admitted directly at TCH. We did not have to wait even five minutes. Our ENT in CS called and made the arrangements, even spoke to the surgeon, and we entered through the ambulance bay and they took her vitals and sent her straight up to her room to get the IV ABX going again. She was in surgery within three-four hours.

I work in healthcare and have had bad experiences at St. Joseph's. The only hospital in town that I even remotely have faith in is Scott and White and that is for basic procedures and consults. Anything major and I go to Houston. Case in point, I have been back here for seven years and still see my gynecologist at Memorial Herman Memorial City. Convenient? No. However, I am BRCA2 positive and I'm not leaving management of that diagnosis up to a local physician. I'm sure there are some good ones here in town and I LOVE my hematologist at Scott and White, but once the word cancer enters the picture, I'm Houston bound.
akaggie
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My daughter was a direct admit at TCH. I think it depends on the situation and how well the local doctor knows how to work the TCH system. Our transition to TCH was seamless.
akaggie
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They took our insurance and were in network. I watch medical bills like a hawk (they all go into a spreadsheet where I track EOBs) and they billed us correctly. What people don't seem to understand is that just because you have BCBS (like I do) that doesn't mean that your employer has negotiated the BCBS contract the same way mine has...I work for a very large company (Fortune 25) and our plan with BCBS is really good. Other companies may not be able to afford (or have the power) to negotiate that kind of plan. Our out-of-pocket max for any given year is $5000. Clearly we hit that VERY quickly with my daughter's illness in January and everything we have had done, including prescriptions, has been free since then.
akaggie
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If you have a $600 ER copay, you need a different insurance plan. I realize that may not be possible, but that is crazy. I know I'm spoiled by our good insurance plan with a large corporation who can negotiate better rates, but you could probably negotiate a cash price for an ER visit that less than $600. You have the right to ask what their cash price is vs their negotiated contract price with your insurance company. Sometimes you might be surprised at the difference.
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