HOUSTON - Gavin Grajales is a typical little boy.
"He's very, very active. I mean, into everything," said Gavin's mother, Holly.
He never stops moving, until something, such as an accident at the park, gets in his way.
"He fractured his wrist and his elbow at the same time," Holly said.
She thought she was taking Gavin to a neighborhood urgent care center, but it was really a free-standing emergency room.
"They X-rayed his arm, gave him some pain medication and they splinted it, and that was it," Holly said.
Then she got the bill.
"It was sticker shock. I don't even know how to describe it. You gave him Tylenol, a splint on his arm and I receive a bill for almost $2,000," Holly said.
Free-standing emergency rooms are not the same as urgent care centers. KPRC first showed you dramatic price differences between the two in 2014.
One example: The cost to treat a urinary tract infection was six times more expensive at an ER than at an urgent care.
It's the same with sinusitis and bronchitis.
Free-standing ERs were a hot business in Texas. Their use is up dramatically since the state licensed these facilities in 2010. But that trend may be coming to an end.
The largest free-standing ER company -- Texas-based Adeptus health -- has seen stock prices plummet. The company is facing a class action lawsuit claiming Adeptus "actively conceals its billing practices and operates a business model meant to "trick patients into believing that its centers are appropriate for non-emergent care for the purpose of extracting extravagant fees."
Adeptus Health has also filed for bankruptcy.
"If we had gone in and said, 'Is this an emergency room? Or is this an urgent care facility?' is the only way we could've known the difference," said free-standing ER customer Ginger Pine.
Pine got stuck with a $1,700 bill after seeing a doctor for a fever and cough, at what she thought was an urgent care center.
"Yes, it's labeled an emergency center. But to me and my husband, we're educated people. We don't know that that means," Pine said.
If the word “emergency" appears anywhere on the building, it's an ER. By law, an urgent care center can't use the word "emergency" anywhere.
It's also important to know which facility can best treat your condition.
You can schedule appointments online. It's open 9 a.m. - 9 p.m., seven days a week with board-certified family physicians on-site. Patients ages six months and older have convenient, walk-in access.
He told Channel 2, especially in Houston, dehydration is a perfect reason to visit an urgent care.
"They could come here and in a matter of 15 minutes be taken to the back, be given an IV and an hour and a half later, they're feeling much better," Melincoff said. "Because it's not really an emergency situation. It's more of an urgent type of situation."
Urgent care is also a good choice for stitches, X-rays, lab tests, broken bones and allergic reactions.
"Where you would (go for an allergic) experience with peanut butter, we can treat that here as well," Melincoff said.
Life-threatening conditions should be treated in an emergency room.
"A heart attack is not here. A stroke is not here. We call 911 and they come here urgently," Melincoff said.
Adeptus declined to comment on the lawsuit, but defended its marketing and signage practices in a statement to KPRC Channel 2 News:
"We actively work to educate patients on when to properly seek emergency medical care with highly visible emergency department signs, informational materials, outreach to the community and patient guidance on arrival. Patient satisfaction is rated above the top 5 percent of emergency departments across the country, according to patients surveyed by Press Ganey. We work to maintain this high level of satisfaction from our patients by delivering exceptional emergency medical care when needed and referring lower acuity patients to urgent care facilities as appropriate."
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