Urgent care asks patient to pay before epinephrine shot

Stephanie Rowell was asked to pay $400 before receiving an epinephrine injection at a TruHealthNow urgent care facility in Purcellville, Virginia, in July. The 53-year-old woman was suffering from anaphylaxis, a severe allergic reaction, after being stung by a wasp on her parents' front porch in Round Hill, Virginia.

Rowell, who has been uninsured since 2025, reported that her arm felt like it was on fire and her face swelled immediately after the sting. Her father drove her toward a hospital 25 minutes away but stopped at the closer urgent care center after 10 minutes. A nurse practitioner diagnosed her with anaphylaxis and recommended an epinephrine shot to reverse the symptoms.

A medical assistant then informed Rowell she had to pay the $400 medication cost upfront. Rowell returned to the waiting area to retrieve her debit card from her father. After she paid, she received the injection. Within minutes, she felt her throat loosen and her breathing improve.

TruHealthNow officials confirmed that the staff requested payment before administering the shot. Preet Takhar, the company's CEO, stated that the clinic's policy in emergencies is to provide treatment first and handle billing later. However, Manbir Takhar, the medical director, explained that the nurse practitioner determined Rowell was stable. Because her condition was stable, the staff asked for payment while the injection was being prepared.

The total bill for the visit came to $605. This amount included the $400 for the medication, a $40 administration fee, and a $165 visit charge. The clinic staff monitored Rowell for 30 minutes after the shot and checked her vital signs, including her blood pressure.

Federal law requires hospital emergency departments to stabilize patients regardless of their ability to pay, but urgent care centers generally do not fall under this requirement unless they are hospital-owned. Barry Furrow, a health law professor at Drexel University, noted this distinction. Alan Ayers, an urgent care consultant, said that while collecting copays at check-in is standard for outpatient medicine, it should not happen for patients facing anaphylaxis.

Rowell's daughter posted a summary of the experience on a Facebook community page, which generated hundreds of comments. Rowell said she was not upset about the final price but felt the timing of the payment request was problematic. She now carries a personal EpiPen.