What's the Difference Between an ER and Urgent Care Visit?

It can be easy to overlook the difference between an ER and an Urgent Care. Both have similarities but both also have distinct differences concerning the services they provide. It’s important to take into consideration the reason a visit needs to be made. There’s are differences in the cost of services. An emergency department is largely considered to be any department or segment of a hospital that is held out to the public as providing emergency services. This includes a medical screening evaluation by a physician (or other appropriate personnel under the supervision of a physician), to determine if an emergency medical condition exists and, if it does, provide the care, treatment, or surgery necessary to relieve or eliminate the emergency medical condition, within the service capability of the facility. Unlike emergency departments, urgent care centers are facilities that offer medical services for minor injuries and illnesses outside of the hospital emergency room setting. Although the services that each provider offers may only be needed temporarily, an individual may require additional or ongoing care depending on the severity of the condition.

On-site Emergency Department

On-site emergency departments afford 24-hour emergency medical services to the general public at a dedicated site within the hospital’s main premises. These facilities have the capability to offer emergency health care services and may offer integrated hospital services to patients within their care. The basic services include, but are not limited to:

  • Ambulance delivery
  • Integrated hospital services
  • Distribute medications
  • Continuous operations (available 24-hours a day, 365 days a year)
  • Medical screenings, examinations and evaluations by a physician, or authorized personnel under the supervision of a physician

A current hospital license, obtained through the Agency for Health Care Administration (AHCA and/or “the Agency”), serves as the primary licensure requirement for on-site emergency departments. On-site emergency departments are subject to the provisions of the Emergency Medical Treatment & Labor Act (EMTALA); enacted by Congress in 1986 in an effort to ensure public access to emergency services regardless of ability to pay. Under the EMTALA, these facilities are prohibited from posting a list of charges.

Off-site Emergency Department

 With an increasing demand for emergency medical services and issues of overcrowding in existing emergency facilities, hospitals have begun to expand their emergency department services to off-site locations. Off-site emergency departments provide 24-hour emergency medical services at a distinct location, separate from the facility’s central campus. Any Florida licensed hospital with a dedicated emergency department may provide emergency services in a location off the facility’s main premises. Off-site emergency departments are required to offer the same services and must comply with the same regulatory requirements as the emergency department located on the hospital's main premises. The basic services include but are not limited to:

  • Ambulance delivery
  • Integrated hospital services
  • Distribute medications
  • Continuous operations (available 24-hours a day, 365 days a year)
  • Medical screenings, examinations and evaluations by a physician, or authorized personnel under the supervision of a physician

A facility must maintain an active hospital license in order to meet the licensure requirement for off-site emergency departments. Similar to on-site emergency departments, off-site emergency facilities are subject to the provisions of the EMTALA and are accordingly prohibited from posting a list of service charges.

Hospital-based Urgent Care Center

 Hospital-based urgent care centers are walk-in clinics owned and operated by a hospital and offer ambulatory care services outside of the traditional emergency room setting. Unlike emergency departments, urgent care centers typically operate during designated business hours and do not offer ambulance delivery services to the public. However, based on their proximity to the hospital, hospital-based urgent care centers have the capacity to afford integrated hospital services to patients under their direct care. The basic services include, but are not limited to:

  • Ambulatory care (outpatient medical care, including, but not limited to, diagnosis, observation, treatment, consultation, intervention, and rehabilitation services)
  • Prescribe medications
  • Make arrangements for additional or long-term health care services
  • Integrated hospital services While the Agency does not license hospital-based urgent care centers separately, they must comply with the ambulatory care requirements found in hospital licensure regulations.

 Hospital based urgent care centers are required to publish a schedule of charges for medical services offered to patients. Posted schedules must include the prices charged to an uninsured person paying for such services by cash, check, credit card, or debit card. The schedule must be at least 15 square feet in size, displayed in a conspicuous location within the reception area of the urgent care center and must include the 50 services most frequently provided by the clinic.

Physician-based Urgent Care Center

Physician-based urgent care centers are owned and operated by a physician or group of physicians and offer ambulatory medical treatment for non-life-threatening conditions on a walk-in basis. A typical physician-based urgent care center is a freestanding office operating during designated business hours, usually staffed by at least one physician, several medical assistants, nurses and other health care professionals. These facilities are usually not equipped to offer integrated hospital services to individuals, and will normally refer patients to either a primary care physician or specialist for advanced testing and/or treatment. The basic services include, but are not limited to:

  • Ambulatory care (diagnosis and treatment of non-life-threatening conditions, such as minor cuts or burns, the flu, or sinus infections)
  • Prescribe medications
  • Make arrangements for advanced or long-term health care services

While the Agency does license and regulate health care clinics, there are currently no separate licensure requirements for urgent care centers. However, a physician-based urgent care center may hold and maintain a health care clinic license—depending on the nature of the business’ operation. Like all urgent care centers, physician-based urgent care centers are subject to the same charge schedule publishing requirements as a hospital based urgent care center.

Health Care Clinic-based Urgent Care Center

Much like physician-based urgent care facilities, health care clinic-based urgent care centers typically offer ambulatory medical treatment for members of the community on a walk-in basis. These facilities usually provide medical care services to individuals at little to no cost and could potentially be a viable option for members of the community that are either uninsured or cannot afford treatment. Additionally, while the Agency does license and regulate health care clinics, there are currently no separate licensure requirements for urgent care centers. However, a health care clinic-based urgent care center must maintain an active health care clinic license.

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Important: If you or a loved one are experiencing a medical emergency, please call 911 or proceed to the nearest emergency room for immediate assistance

Note: This is not designed to offer medical or legal advice. Please talk to your insurance provider about the facilities and services that are covered under your policy. Additionally, please consult with your doctor for medical advice and an attorney for legal advice. Information derived from ahca.myflorida.com