With both an Emergency Room and 24/7 Urgent Care Center, we have the flexibility to bill patients according to their level of treatment. That means you won’t be charged ER prices for an Urgent Care visit, unlike other facilities. And because insurance policies are so complicated, we always bill at in-network rates to help keep your out-of-pocket cost as low as possible.
What can you expect regarding cost? Because of lower overhead, our Emergency Room prices are often less than those of a traditional hospital-based ER—even though we have the same capabilities, equipment and experienced doctors and staff. And you will find the cost of an Urgent Care visit similar to that of a doctor’s office.
Calculating Your Bill
America’s ER Medical Centers (“AER”) is publishing its service fees to help our patients understand both their healthcare costs as well as what their health insurance company is required to cover. While AER is solely responsible for the fees appearing on its charge master, AER derives those fees from the licensed Emergency and Urgent Care charge data it receives from Fair Health, Inc. (“Fair Health”).
Fair Health is an independent and neutral, national nonprofit organization. It is neither affiliated with nor controlled by healthcare insurance companies or healthcare providers. In fact, Fair Health was specifically created to increase transparency to consumers like you by providing nonbiased and accurate information regarding the cost of healthcare services you’d expect to find in your community. In fact, the Texas Department of Insurance recently selected FAIR Health to provide healthcare cost benchmarks data to support the state’s price transparency initiative. Fair Health can offer consumers this reliable information because each year, health insurers around the country send it over a billion healthcare bills which are added to its ever growing database of more than 25 billion healthcare claims. Fair Health maintains the accuracy of healthcare information by making its data specific to the geographical area where healthcare services are provided and by updating that geographically specific healthcare data twice a year.
While Fair Health retains all rights in and to the information in its healthcare database, AER utilizes that accurate and non-biased data to establish and regularly update its usual and customary charges so those charges always approximate the costs listed in the 80th percentile of Fair Health’s charge data. Fair Health’s healthcare information, including the data used by AER to develop its service fees, is publically available to everyone at Fairhealthconsumer.org.
While Fair Health does not publish charge data for professional services rendered in an emergency room, AER utilizes the facility charge data that is published by Fair Health to establish it’s usual and customary professional service charges. This charge approximation is accomplished by attempting to employ the same methodology used by the Centers for Medicare and Medicaid Services (“CMS”) to determine reimbursement for professional services rendered to CMS patients.
In-network vs. Out-of-network
Did you know that federal law requires all private insurance companies to reimburse Emergency Room visits at in-network rates—even if the facility is out-of-network? The purpose of this law is to prevent the loss of valuable time by a patient attempting to locate an in-network emergency facility simply to satisfy an insurance company restriction. So your insurance company cannot deny your Emergency Room claim or reimburse the facility fee at out-of-network rates. However, the treating physician may or may not be in your specific plan’s network, and therefore your insurance company may potentially reimburse out-of-network rates for the physician fee.
We understand that dealing with a health insurance claim is often a frustrating experience. Understanding the process of medical billing and the details of your specific policy—individual and family benefits, co-pays, deductibles and co-insurance—can be rather confusing. Knowing the details of your specific policy can help you make informed decisions regarding your medical care.
Our friendly staff will gladly answer any questions you may have, clarify what you actually owe, and will work with you each step of the way to make the experience as easy and convenient as possible.
Other Payment Methods
For patients who do not have insurance or do not want to use it, we offer a substantial discount when payment is made in full at the time of service. America’s ER accepts all major credit cards and can also arrange scheduled payment plans or third party financing options for qualified patients.