Choosing the appropriate type of care for a medical condition accomplishes several important things, including:
- choosing the appropriate level of treatment for the medical condition
- making the best use of time by selecting medical care wisely
- ensuring highly specialized, expensive emergency room resources are used efficiently
Urgent care
If a condition arises and it can’t wait until a scheduled appointment with a primary care manager, urgent care may be an appropriate choice. However, before doing so, contact a PCM before going to urgent care.
PCMs can be contacted anytime of the day at (623) 856-2273 to discuss symptoms. The PCM can assist members over the phone and help them decide on the most appropriate medical resource.
Staff at urgent care centers cannot answer medical questions or advise members over the phone. In general, if the illness or injury is something that would require a member to be seen by a PCM but an appointment can’t be made right away or if it’s after hours, urgent care is the right choice. If urgent care is needed, members can request a referral by calling (623) 856-2273.
Reasons urgent care may be needed are:Â
- Minor lacerations
- Asthma
- Bites, animal or insect
- Migraine headaches
- Vomiting
- Rising fever
Hospital emergency room
TRICARE defines an emergency as a medical, maternity or psychiatric condition that would lead a “prudent lay person†(someone with average knowledge of health and medicine) to believe that a serious medical condition exists, or that the absence of immediate medical attention would result in a threat to life, limb, or eyesight, or when the person has painful symptoms requiring immediate attention to relieve suffering. This includes situations where a person is in severe pain or is at immediate risk to self or others.
An emergency room is prepared to treat life-threatening illnesses and injuries 24/7. The emergency department sees patients in order of priority, based on the seriousness of their conditions. If you use the ER for nonemergency conditions, a long wait can be expected. It’s important to keep hospital emergency departments open for true emergencies.
If someone is unconscious, having trouble breathing, has suffered a serious injury, or may be having a heart attack, call 9-1-1 immediately. If a condition appears serious, paramedics should be called. They are specifically trained to stabilize emergency patients and coordinate their care with the most appropriate hospital emergency department for treatment. In a life-threatening situation or in the case of a serious medical condition, go directly to the nearest emergency room. Inform the emergency room staff of the PCM’s name so they can better coordinate care. Some examples of serious medical conditions or symptoms requiring emergency care are:
- Severe bleeding
- Chest pains
- No pulse
- Inability to breathe
- Spinal cord or back injury
- Severe eye injuries
- Broken bones
By making prudent choices when seeking treatment at an urgent care clinic or a hospital emergency room, members save money and being good stewards of precious medical resources.
For more information about TRICARE benefits, visit www.TriWest.com or call (888) 874-9378.
