Consumer Guides

EMERGENCY AND URGENT CARE

Introduction

This brochure provides information about facilities that provide health care services in either an emergency department or urgent care center setting. 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.

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.

Topics Include:

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 general 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 outlined above.

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.

Find a Provider

You may want to compare several providers of emergency and urgent care services in your area before the need arises in order to determine which one best meet your needs. The following resources can help in your search:

  • You can use Facility Locator on FloridaHealthFinder.gov to find providers in your area. After you have a provider or list of providers, click on a provider name to find the address, phone number, and driving directions. The profile page also includes the administrator and owner, a link to inspection reports, and emergency actions and/or legal sanctions (where applicable).
  • For a list of on-site and/or off-site emergency departments, visit the Facility Locator page. Under the "Facility/Provider Type" drop-down item, select "Hospital". Once this facility type is selected, under the "Advanced Search" field, select "Yes".
  • You can also use Facility Locator to select an emergency department on the basis of the emergency services provided. To search facilities by available emergency services, select "Hospital" under the "Facility/Provider Type" drop-down menu. Once selected, select the "Emergency Department" drop-down option located under the "Advanced Search" field and select "Yes". Click the "Emergency Services" drop-down item to select a service from anesthesia to vascular surgery services. Once you've selected an emergency service, click the "Search" button to generate your customized facility list.
  • For a list of hospital-based off-site outpatient locations, visit the Facility Locator page. Under the "Facility/Provider Type" drop-down item, select "Hospital". Once this facility type is selected, visit the "Off-Site Outpatient Locations" drop-down option located under the "Advanced Search" field and select "Yes" then click "Search".
  • Urgent Care Association of America (UCAOA) : Visit UCAOA's website for a list of urgent care centers in Florida who are members of the association. Urgent care centers provide health care services for minor injuries and illnesses without having to go to a hospital emergency room. Care at these clinics is less expensive than in a hospital emergency room, but may be more expensive than the providers listed above.
Questions You May Want to Ask an Emergency or Urgent Care Provider

Following are topics you might want to discuss with the provider, along with any other questions you may have.

  • Ask what type of payment is accepted. Certain medical services may be paid by private funds, some insurance policies, Medicaid, Medicare, or other government programs.
  • Ask if any services are provided by another entity, and if so, do they bill separately and what type of payment do they accept.
  • Ask for a list of emergency medical services offered by the facility or, alternatively, if the facility has the capability to provide a specific service that you may require.
  • Ask for a written description of the cost and services and ask that they be clearly explained.
Resources

The following resources might be helpful when you or a loved one are ready to choose an emergency or urgent care provider and want to research programs that might help pay for some services.

  • If you have a health insurance policy, or are considering buying one, find out exactly what it covers, under what conditions you can receive coverage, any restrictions that might apply, and what you need to do when coverage is needed. The Florida Department of Financial Services regulates insurance in Florida. For questions or to request their consumer materials, call the toll-free number (800) 342-2762 or visit MyFloridaCFO.com.
  • Ask your local County Health Department, social service agency, medical association, or call the phone number 211, to see if they know of any programs that offer donated health care service in your area.
  • Visit the U.S. Department of Health and Human Services' Health Resources and Services Administration to find a health care clinic that provides medical services, even if you don't have insurance or money. You can also reach out to the Florida Association of Community Health Centers for additional resources on health care services.
  • Contact your local County Health Department for availability of direct medical services or information on other programs where you can get care in your community. To find the office in your area visit the Florida Department of Health's website and search for your county.
Important Links and Numbers

Agency for Health Care Administration (AHCA)

  • To file a complaint against a facility call the toll-free number (888) 419-3456 or complete a complaint form online.
  • Find information on facilities and providers such as licensure information, driving directions, specialty licenses, inspection reports, emergency actions and much more at FloridaHealthFinder.gov

Department of Children and Families (DCF) - DCF takes applications and determines who is eligible for Medicaid, Medicaid waiver programs, and Optional State Supplementation (OSS). Call them toll-free at (866) 762-2237 or visit their website using the link provided above.

Department of Elder Affairs (DOEA) - Contact DOEA for information on memory disorder clinics, demographic profiles on elders, legal assistance, elder abuse prevention, disabilities, mental health, relocating to Florida, information for caregivers, senior employment, guardianship, volunteerism, and disaster preparedness. Call them toll-free at (800) 963-5337 or TDD (800) 955-8771 or visit their website using the link provided above.

  • Area Agencies on Aging Offices - Provides information and assistance about state and federal benefits, and available local programs and services.
  • Elder Care Services Helpline - For referrals to health care facilities or other elder services.
  • SHINE (Serving Health Insurance Needs of Elders) - SHINE is for seniors and people with disabilities and provides counseling to seniors regarding health insurance, including Medicare, Medicaid and prescription drug.

Department of Financial Services

Consumer Services - The Department of Financial Services' Consumer Services can provide booklets covering a wide assortment of insurance issues - including long-term care and Medicare supplement insurance. Consumer Services can also answer questions about insurance companies and help mediate consumer problems/complaints with insurance companies. Contact them at (800) 342-2762 or by using the link provided above.

Centers for Medicare and Medicaid Services (CMS)

Medicare Hotline - The Medicare Hotline can be reached at (800) 633-4227 or at http://www.medicare.gov/.

Additional Consumer Guides Include:

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 is current as of April 2016.

This may be copied for public use. Please credit the Agency for Health Care Administration for its creation.

If you have comments or suggestions, call (850) 412-3730.