A Virginia woman seeking help for a potentially life-threatening allergic reaction said she was asked to pay $400 before receiving the medication she needed.
Here's what to know
Stephanie Rowell, a 53-year-old agritourism business manager living in Round Hill, Virginia, developed itching, facial swelling, and throat tightness after a wasp sting in July, KFF Health News reported.
Hoping for faster care, Rowell and her father stopped at TruHealthNow in Purcellville, she said, rather than continue to the emergency room he was driving her to.
Rowell said her father retrieved her debit card after a medical assistant requested $400 upfront. The payment request followed a nurse practitioner's diagnosis of anaphylaxis — a potentially life-threatening allergic reaction — and a recommendation that she receive epinephrine.
TruHealthNow confirmed that payment was requested before the injection but disputed that the request delayed treatment. Medical director Manbir Takhar said Rowell was stable. TruHealthNow said staff prepared the shot while handling payment.
The final bill included a $400 medication charge, a $40 administration charge, and a $165 visit charge, according to KFF Health News. Rowell said her symptoms eased within minutes of receiving the injection.
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More background
Rowell said she was uninsured because it became too expensive in 2025.
While hospital emergency departments must stabilize patients regardless of their ability to pay, urgent care centers generally operate under different requirements, according to KFF Health News.
Barry Furrow, director of Drexel University's health law program, explained that urgent care centers generally fall outside that federal requirement unless they are hospital-owned. TruHealthNow's eight privately owned and operated centers are located in Maryland and Northern Virginia.
According to the Urgent Care Association, as reported by KFF Health News, urgent care visits totaled about 185 million in 2025 across more than 15,000 centers.
These clinics treat conditions such as the flu, sprains, and minor cuts, but they are not intended for life-threatening emergencies.
The possibility of a recurring reaction is why monitoring is recommended after treatment for anaphylaxis. Epinephrine can keep the reaction from advancing to life-threatening shock.
TruHealthNow said staff observed Rowell for the half-hour after her injection.
What can be done?
Ryan Stanton, who leads the American College of Emergency Physicians and works as an emergency physician in Lexington, Kentucky, advised going to the nearest emergency room or calling 911 when unsure whether symptoms indicate an emergency.
Trouble breathing and chest pain are reasons to seek emergency-department care.
Stanton also recommended that people with life-threatening allergies carry a prescribed EpiPen and keep one at home. Rowell said she now carries one.
Rowell also said her brother stayed with her after she left urgent care to watch for complications, and her recovery took several days.
TruHealthNow CEO Preet Takhar said the company's emergency policy prioritizes treatment over billing.
Arthur Caplan, an emeritus professor who formerly led medical ethics at New York University's Grossman School of Medicine, said clinicians have an ethical responsibility to help during emergencies, according to KFF Health News.
"You don't need to have a patient go fumbling around for a credit or insurance card [in a life-saving situation,]" he said. "If you have the skill to take care of someone, you should."
Where can I learn more?
Unexpected medical bills and treatment delays can happen outside urgent care, too.
• A patient faced a $500 bill after annual lab tests at an in-network hospital.
• After a patient disputed an $85,000 hospital bill, an AI sweep found $20,000 more.
• A Humana Medicare Advantage patient's cortisone shot cost rose from $35 to $319 after a billing switch.
• In Hatfield, Massachusetts, EMS sought $1,178 per ambulance call, saying the town wasn't contributing.
• An Illinois woman said she was left vomiting for hours after ER staff took her vitals.
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