Family With Insurance Denied Urgent Medical Care
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CHICAGO (CBS) — When a child runs a fever on the weekend or gets sick in the middle of the night, parents often rely on a local medical care center for treatment.
That is where a suburban family took their 5-year-old daughter, who was struggling with a fever and asthma. Instead of getting treatment, the family was turned away, even though they had insurance, CBS 2 Investigator Dave Savini reports.
“I was really angry to find she needed medical care, and the place that they went to turned her away,” said Michelle Wysocke, whose daughter, Isabella, had to be raced to an urgent care center on the advice of her pediatrician.
“She was breathing very tight,” said Wysocke. “That could have led to a full-blown asthma attack.”
Paul Smith, Isabella’s father, drove her to a facility in Schaumburg that had a sign on the door saying “urgent care” and a neon “urgent care” sign in the window. Facilities using the term “urgent care” have to be affiliated with hospitals and must follow the emergency room rule: Patients can not be turned away.
However, Smith said, his daughter was refused treatment.
“They turned me away,” said Smith, because his daughter was on Illinois’ All Kids insurance plan. They were turned away even though the center’s website said they, “accept all health plans.”
“So, I said, ‘She’s sick, so please see her,’ ” said Smith. “I was aggravated. I was worried about her health getting worse.”
Azzy Baig, administrator for the center, Schaumburg Immediate Care, says he made a marketing mistake. The facility is actually an immediate care center, which is a step below an urgent care facility. That means his facility could turn away patients.
In this case, Baig says treatment was denied because of a rule change with the All Kids program. Patients now have to list his center’s doctors as their primary care physicians in order for the visit to be covered. It could be difficult to make that switch on the weekend.
“It breaks my heart to see this guy, anybody who comes in, and I’m not able to serve them,” said Baig.
Baig admitted his website stated all insurance is accepted, and the “urgent care” signs on his door and window are both wrong and could be misleading.
“I understand the law,” said Baig. “I know it’s wrong.”
Baig got rid of the window signs and changed the website.
In Isabella’s case, her father ended up rushing her to a hospital emergency room and they stabilized her.
Smith says he was worried during the drive to the hospital. “Her breathing could have gotten a lot worse. She could have stopped breathing in the car. I could have to call an ambulance and wait for an ambulance. I mean anything could have happened.”