Our billing procedures
At Family ER + Urgent Care, we want you to make sure that you and your loved ones are treated with the utmost respect, compassion, and fairness. We are committed to providing the highest quality emergency care on the market and billing you appropriately for services rendered.
Any time you visit our facility, our physicians will explain to you whether or not you have a potential “Emergency Medical Condition”. If you have an Emergency Medical Condition, we will complete the care until you are discharged or transferred to a hospital for admission, regardless of your ability to pay. We care about YOU first!
I have private insurance (Blue Cross/Blue Shield of Texas, Aetna, Cigna, etc):
- Currently, Family ER + Urgent Care and Family ER + Urgent Care physicians are out of network providers. However, state law mandates that your insurance plan cover your emergency care as if it were “In-Network” whether or not you choose an “In-Network” or “Out of Network” Emergency Care provider.
- Emergency Care in the State of Texas is determined by the “Prudent Lay Person Standard”. This means that if the average non-medical individual would consider your condition an emergency, then your insurance should cover you as if you were visiting an “In-Network” provider/facility.
- You are still responsible for your deductible and co-pay.
From 8:00 am to 8:00 pm Fast Track/Convenience Option:
- Between the hours of 8:00 am and 8:00 pm, if you present to our facility and our Emergency Physicians determine that you do not have a medical emergency, you may be able to seek care at an Urgent Care facility or at your doctor’s office. However, during these hours, we understand that you chose us because you trust us. We will bill you and your insurance company at an appropriate lower rate than a hospital ER would charge during the same hours for your convenience. In this case, our physicians will inform you that you are a “Fast Track” eligible patient.
- Because we are a full service Emergency Room, legally, we are required to charge you the Emergency Room Co-Pay. However, as a Fast-Track patient, your responsibility for Deductible and Co-Insurance will be much lower.
- Our registration staff will verify your insurance benefits during your visit. They will be able to provide you with an estimate from the physician as to what you will be responsible for paying for your care.
- You may choose to pay the self-pay rate and not file with your insurance if you desire. This could be as low as $150.
Emergency Care and After Hours:
- If you visit our facility at any time of day and our Emergency Physicians determine that you have a potential “Emergency Medical Condition”, we will inform you of our plan for your care. If you visit after 9:00 pm, this will automatically be considered Emergency Care. However, if our physicians feel that you can wait to see your doctor in the morning, they will give you that piece of mind free of charge.
- If you have an Emergency Medical Condition, we will collect your co-pay and you will have the opportunity to pay the portion of your estimated deductible.
- Once our billing company has assessed all of the charges, they will bill your insurance company and you will be informed of any remaining deductible or co-insurance charges that you are responsible for.
- If you are unable to pay that amount at the time of your visit, our staff will request a good faith deposit if applicable.
- Since all insurance companies are different, we can never guarantee that the estimate we provide at discharge is accurate. However, we will do our best to give you a rough estimate of the bill you may receive.
- If you are unable to pay your bill in full when it arrives, please contact our billing company and they will assist you with a payment plan.
I have insurance, BUT I have a high deductible plan greater than $5,000:
- Family ER + Urgent Care understands that no one anticipates that they will need emergency care and that this can impose an unforeseen financial strain on our patients.
- Our registration staff will inform you and your physician of your remaining deductible and will provide you with an estimate of what will be sent to your insurance company.
- If you choose, you may opt to pay a discounted rate at the time of service in full. This will not be billed to your insurance company. However, you will be able to submit your payment to your insurance company to apply towards your deductible.
- If you choose to pay in full at the time of service, then our billing company will provide you with the necessary documentation to submit to your insurance plan for credit towards your yearly deductible.
- We highly recommend you read and understand your insurance plan benefits.
I am a Medicare, Medicaid, or Tri-Care Beneficiary:
- Freestanding Emergency Centers are a new concept to the American health care system. Due to the newness of these types of facilities, CMS (The Center for Medicare and Medicaid Services and Tricare) does not recognize Freestanding Emergency Centers as potential providers of health care. Therefore, we are prohibited from billing CMS for our services by Federal Law. This is not our choice. We recommend that you contact your Congressman and inform them that you would like to be able to have your Emergency Care covered when you visit freestanding emergency facilities like ours.
- If you do not have an Emergency Medical Condition, our physicians will explain that to you and explain your alternative options for care.
- If you are found to have an Emergency Medical Condition, we will treat you regardless of your Medicare, Medicaid, or Tricare status.
I do NOT have insurance:
- Our Emergency Physicians will evaluate you on arrival and determine if you have an “Emergency Medical Condition”.
- If you do not have an “Emergency Medical Condition”, our physicians will share alternative options for care with you. If you choose to stay, our registration staff will inform you of the cost of your visit should you choose to stay to complete your care. If you choose to stay and not seek care at the recommended alternative sites, we will collect any balance you may owe prior to the completion of treatment. After you pay this balance, you will not receive any further bills.
- If you have an Emergency Medical Condition, we will evaluate this to the fullest extent. You will be responsible for all charges incurred during your visit. We do offer a discounted rate for patients that choose to pay out of pocket. You may request a payment plan with our billing company if you are unable to pay your bill.
Our billing procedures:
- Family ER + Urgent Care is currently an ”Out of Network” provider for all insurance carriers. Federal and state laws mandate that insurance carriers reimburse emergency services regardless of whether the covered individual is treated at an “In-Network” or “Out of Network” emergency room. This applies to the emergency services provided by our facility as well.
- Family ER + Urgent Care is not a participating Medicare, Medicaid, or Tricare facility.
- If your physician determines that you do not have an Emergency Medical Condition and you choose to receive Non- Emergency care at our facility, you will be responsible for payment of the services rendered.
- The physician services provided by Premier One Emergency Physicians, PA will not be included with the Family ER + Urgent Care billing statement.
- You may see a listing of physicians who have been granted medical staff privileges to provide medical services at this facility via review of Family ER + Urgent Care website, which also includes contact information for Family ER + Urgent Care physicians, PA physician.
- The Department of State Health Services, Patient Quality Care Unit-Health Facility Compliance is the responsible agency for facility complaints that are unresolved by Premier One. The disclosure will include the Department’s contact information:
Department of State Health Services, Patient Quality Care Unit-Health Facility Compliance
P.O. Box 149347, Mail Code 1979
Austin, Texas 78714-9347
Telephone (888) 973-0022