Insurance & Policy Information
New, Existing & Uninsured Patients
We are responsible for offering medical screening examinations to all of our patients, regardless of their ability to pay for the treatment. In case the screening exam depicts the patient is in danger or at risk of furthering serious complications, then our team is required to stabilize the patient immediately without putting their ability to pay for the treatment as a prime concern.
A ‘medical emergency’ involves; a medical condition consisting of severe pain that would allow a layperson having average knowledge of health and medicine to assume the condition, injury, or illness, is one that requires immediate medical attention and may cause one of the following life-threatening complications:
- Severe body impairments
- Putting the patient’s health in grave danger
- Serious organ dysfunction
- Critical disfigurement
- Harsh implications to the health of a fetus in pregnant women
Pricing Policies
- This facility is a freestanding emergency medical care facility.
- This facility charges rates comparable to a hospital emergency room and may charge a facility fee.
- This facility or a physician providing medical care at this facility may be an out-of-network provider for the patient’s health benefit plan provider network.
- The physician providing medical care at this facility may bill separately from this facility for the medical care provided to a patient.
- This facility is an out-of-network provider for all health benefit plans
- Este centro es un centro de atención médica de emergencia independiente.
- Este centro cobra tarifas comparables a las de una sala de emergencia de un hospital y puede cobrar una tarifa de instalacion.
- Este centro o un médico que brinda atención médica en este centro puede ser un proveedor fuera de la red para el proveedor del plan de beneficios de salud del paciente
- El médico que brinda atención médica en el centro puede facturar por separado de este centro por la atención médica brindada a un paciente.
- Este instalación es un proveedor fuera de la red para todos los planes de beneficios de salud
Nevertheless, under both the Federal and Texas law, insurance companies are responsible for paying the patient’s in-network emergency services once the patient has paid for the plan that covers deductibles and co payments.
Consumer Liability
For any services available at Priority ER Care, patients/guarantors are required to pay all charges associated with those services. We will gladly accept a patient’s verified insurance card at the time of service or when filing a claim on their behalf.
Insurance claims are usually filed within the 30 days of a patient’s visit. In case the patient’s insurance company hasn’t paid the claim within 90 days, then the patient/guarantor is required to pay all outstanding balances.
Statements
An itemized claim is generally filed on behalf of insured patients. Once your claim has been processed successfully, your insurance company is responsible for providing an itemized Explanation of Benefits. On the other hand, patients that paid in cash or are uninsured, you will be given an itemized statement of the charges.
Copies of Records – If a third-party entity or a consumer asks for more than two copies of the medical records, we will charge an affordable fee for every extra copy after that.
Senate Bill 425 And House Bill 3276
NOTICE OF FEES – Priority ER Care in compliance with Senate Bill 425, effective January 1, 2016, and modified by House Bill 3276, effective September 1, 2017, please notice the following:
- Priority ER Care is a freestanding medical care facility.
- Our rates are comparable to a hospital emergency room and we may charge a facility fee.
- Our physicians may or may not be a participating provider in your health plan provider network; you may need to check with your healthcare benefit provider.
- Our facility is not a participating provider in any health benefit plan provider network. However, by state law your health insurance company is required to process your emergency visit at in network benefit levels.
- Your physician providing medical care today may bill separately from the facility for the medical care provided to you.
House Bill 2041
Priority ER Care makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and Priority ER Care cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill for services rendered at Priority ER Care may differ substantially from the information provided by this website, and Priority ER Care shall not be liable for any inaccuracies.
As required by the Texas House Bill 2041, here is a complete list of charges for all services and items provided by our facility.