About 1,800 Humboldt County patients in Western Health Advantage plans now need prior authorization for insurance to cover visits to out-of-network Redwood Urgent Care under a Providence policy change issued July 15.
Providence said the move is meant to keep urgent-care use in network and lower insurance costs for both the health system and patients, since Redwood is not contracted with Providence.
Patients who use contracted urgent care providers do not need advance approval, but Redwood is the county's only urgent care clinic of its kind; without authorization, patients must pay out of pocket or go to Providence's St. Joseph emergency room.
Providence's regional CEO said harm is unlikely because patients can get same-day weekday primary care and telehealth from 8 a.m. to 8 p.m., with urgent-care visits typically approved when those options are unavailable.