FAQs – Understanding the ER bill
If you have a question that is not answered here, feel free to get in touch with us. We look forward to addressing your questions.
What is the billing process at Excellence ER?
The billing procedure at Excellence ER is quite flexible and very similar as that of a conventional hospital based ER. Copays are collected at the time of service. If there’s any previous deductible balance or any co-insurance payments due, you may be required to pay that off. The patients will be be billed for the services rendered at the ER and a copy of the bill will be mailed to their address. If you have any questions, please call us at Excellence ER.
What if Excellence ER is not in my insurance network?
By law, you must be reimbursed by your insurance carrier for your emergency room visit.
As per Texas Guidelines, all the insurance carriers are required to pay in-network benefits for any member presenting for emergency medical treatment.
Moreover, Texas law requires insurance carrier to pay for a patient’s emergency care, whether the emergency room is “in network” or “out of network.” The state of Texas empowers you to use “a prudent layperson standard” in deciding what constitutes an emergency.
What if I have troubles with my insurance company?
According to State law, insurance carriers have to reimburse patients for their visits to the emergency room. In case, your insurance company refuses to cover your emergency room visit, you have the right to file a grievance with the Texas Department of Insurance. To learn more about the Texas Department of Insurance, please refer to their website: http://www.tdi.state.tx.us
Who will answer queries about your bill?
Most patients find medical billing to be a complex process. At Excellence ER, we have a fair and transparent billing system. In case you have any questions regarding billing or insurance, please contact us at firstname.lastname@example.org. We will do our best to answer your questions.
What is a patient advocate and how can you contact them?
At Excellence ER, we provide a patient advocate to our patients; the advocate assumes the responsibility of providing guidance to patients helping them understand the ER Bill and to service as a liaison between the facility and the patient.
What insurances do we accept ?
Excellence ER accepts all the major private insurance plans like Aetna, Blue Cross/Blue Shield, United Healthcare, Humana, etc. Regrettably, we do not accept Medicaid or Medicare currently. In case you do not have insurance, we can work with you to devise a cash fee schedule to enable you to cover your visit. We assure our patients that they won’t encounter any hidden fees or charges.
I received an Explanation of Benefits (EOB) after my visit to the ER. Is that my bill?
After a visit to the emergency room, you will receive an Explanation of Benefits (EOB). The EOB is NOT your bill; it is a statement from your insurance company that is sent to you and to Excellence ER to explain the medical services that were covered and paid for.
What are my payment options if I cannot pay my balance in full?
In situations where a patient is unable to pay the balance in full, multiple payment options can be utilized through Excellence ER’s billing office. A down payment followed by consecutive monthly payments can be made to cover the entire bill gradually. For more information, please contact us at email@example.com
FAQs – What patients should know
What is the difference between a hospital’s ER and a freestanding emergency room like Excellence ER ?
A freestanding emergency room is structurally different from a hospital emergency room physically attached to a hospital. However, it essentially provides the same level of quality care in an emergency situation and is open 24/7. Freestanding ERs operate independently, are usually situated in accessible neighborhoods, have flexible payment mechanisms and have much shorter wait-times than conventional ERs.
When should patients visit an urgent care?
If a patient needs immediate medical attention that is non life-threatening and it does not merit a visit to the ER, It is advisable to visit an Urgent care or a PCP. However, if the medical situation is serious and deemed an emergency, patients are referred to a local ER, such as Excellence ER.
Do we provide emergency care services to children?
Excellence ER’s physicians are experienced and trained in pediatric emergency care to provide personalized service to children in the event of an emergency or illness.
We understand that these medical emergency situations are stressful for both parents and children. Our ER facility is much calmer and less rushed than traditional emergency room settings. We even assign special rooms for our child patients to ensure the children are cared.
How is Excellence ER different from conventional Emergency Rooms?
Excellence ER is your personal emergency room that is open and accessible 24/ 7, just like traditional emergency rooms.
Unlike long queues, waiting times, and rushed environment at hospital based ER’s, when you come to Excellence ER you would come across a calm and controlled environment and would be treated within a few minutes of your arrival.
We’ll also follow up with your primary care physician to ensure optimum communication between all of your care providers.
What insurance do we accept?
Excellence ER accepts all major private insurance plans like Aetna, Blue Cross/Blue Shield, United Healthcare, Humana, and others. We also work on a cash fee schedule with those patients who do not have insurance, to help them cover their medical visit to the ER.
What if i need to stay in the hospital?
In certain situations, patients are required to stay at a hospital.We can keep patients under observation for up to 23 hours. For stays longer than 23 hours, we have agreements with local healthcare facilities to ensure that you are transferred to the hospital of your choice.
We will also help you choose the hospital that’s best for you according to your situation.
What if you require additional care or surgery?
In cases where patients need to be treated with an in-depth procedure that can only be performed at a hospital, we assume the responsibility and take care of all the details. You can also decide to skip the visit to the hospital’s ER and be admitted to a room at your arrival. To ensure a smooth transition, we can even furnish you with practitioner referrals.
LEARN ABOUT TEXAS SENATE BILL 425
Senate Bill 425 relates to healthcare and the fees charged by freestanding emergency centers. Excellence Emergency Rooms are freestanding emergency centers that provide immediate medical care and charge rates comparable to hospital ERs and may charge separate facility fees.
In some cases, patients may also be treated by physicians who are out of network and/or may be billed separately by the physician providing medical care.
ANY OTHER QUESTIONS ?
Call us for your queries right away.
Corporate Location : 2401 Fountain View Drive, Suite 808 Houston, TX 77057