Frequently Asked Questions

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The Emergency Center Answers Your Questions

The Emergency Center is a freestanding comprehensive emergency medical care center. We are similar to, and in many ways better than a hospital based emergency room. Emergency centers have everything you need for an emergency in your neighborhood. Our facility is staffed 24/7 with board-certified physicians, ER trained registered nurses. Just like hospital based ER’s, TEC has an on-site lab and a full radiology suite with CT, digital x-ray, and ultrasound.

Unlike urgent-care centers, freestanding emergency centers are required to be open 24 hours a day – 7 days a week, have ER physicians on-site at all times, provide round-the-clock lab and imaging services, keep medications in stock and be able to provide life-saving care immediately. Urgent care centers almost never have CT scanners, ultrasound, and full lab capability within their facility but freestanding ERs are required to have these available at all times. As state-licensed facilities, freestanding emergency rooms must also train their staff at a level not required of urgent-care centers.

The Emergency Center provides the same emergency treatment patients receive in traditional hospital based emergency rooms. While the national average wait time to be treated in most hospital- based emergency rooms is 2-4 hours, patients at The Emergency Center will be seen immediately by a licensed physician or ER-trained Registered nurse who will assess needs and begin care right away.

The Emergency Center or the physicians treating you may not participate in your health benefit plan’s provider network, however, Texas law (Texas Insurance Code, Sec 1301.155) mandates that an insurer provides reimbursement at the preferred level of benefits for out of network emergency care.

Federal law requires individual and small-group plans to offer a package of services known as essential health benefits. The essential health benefits include emergency services. Your insurance should cover emergency visits.

Because of these laws, The Emergency Center or the physicians treating you may not participate in your health benefit plan’s provider network; however, these laws provide for coverage in an emergency regardless of the participating status of your plan. If necessary, TEC has a patient advocate that will work with you to understand and coordinate payment with your insurance company.

Our fee schedule is very similar and often lower than nearby comparable hospital emergency rooms As is standard for most emergency rooms, your insurance will be billed a facility fee and a physician fee. All health plans are different and may require a copay at the time of service. Depending on your insurance you may also have co-insurance or a deductible.

We will accept any initial payment due at the time of service, and then claims will be submitted to your insurance carrier to be applied towards your emergency department benefits. These amounts vary greatly depending on your plan and any deductibles you have met already. We use a software tool that is able to query major insurance companies to determine the status of your insurance at the time of service.

Your insurance will receive two claims, one from the ER physician examining you, and one from the facility. If you have an ultrasound, X-ray or CT scan performed, an additional claim will be filed from the radiologist who read your image.

It is important that you provide the hospital registration personnel with the most accurate insurance information. This will ensure that the proper billing procedures will take place and that you have a clear understanding of the billing processes and your financial responsibility.

Federal and State legislation has provided protections for members of health plans under the ‘prudent layperson’ standard. This means that if a prudent layperson would have felt that your presenting problems represented an emergency and that delaying care to find a contracted physician or to get ‘prior authorization’ from your health plan would have worsened the condition, the plan is obligated to cover those services at in-network rates.

Sometimes, insurance companies will attempt to claim that the facility is not in network and attempt to make you responsible for a greater portion of the bill. This is illegal in the State of Texas. If this happens, do not panic. Most likely, our billing company has already addressed this and has filed an appeal. However, should you receive any communications from your insurance like this, please let us know so we can resolve the issue. It is rare that we do not resolve the issue without requiring you to be involved.

We understand the hassle that many insurance companies make patients go through. We will do everything possible to help you with your financial responsibility. We have seen insurance companies outright deny coverage for premium paying patients because the physician group is not a ‘contracted provider.’ This is unethical at best and illegal in many cases. There are steps you can take to encourage your insurance company to pay for the coverage you need.

ATTENTION PATIENTS – Pursuant to Senate Bill 425, please note:

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 the facility may not be a participating provider in your health benefit plan provider network; and the physician providing medical care at this facility may bill separately from the facility for the medical care provided to you.