Some of our hospital-based competitors make much of the fact that they are contracted with and thus “in-network” with most of the major health insurance plans. When you see this marketing message, you can assume that it really means that they do not have much else good to say about themselves.
The truth is that one of the small benefits of the ACA (Obamacare) is that it requires health care insurers to reimburse all emergency medical facilities and providers on an in-network basis (i.e., use in-network deductibles, co-pays and co-insurance rates) for all emergency medical services.
Sometimes the health care insurers attempt to avoid these ACA (or other) payment obligations and this can possibly result in billing issues for any patient. This is particularly true if the emergency medical services provider fails to properly monitor and appeal inappropriate reimbursement practices by the health care insurers.
We at Elite Care ER Houston recognize this fact and we do not let this happen. For us, Elite Care does not stop with medical care.
Because CMS (Center for Medicare and Medicaid Services) does not yet recognize Freestanding Emergency Departments, Elite Care 24 Hour Emergency Room cannot accept Medicare or Medicaid at this time.
Pursuant to Senate Bill 425 and House Bill 3276, the following is for your information:
- 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.
- This facility is not a participating provider in any health benefit plan provider network. However, under the Affordable Healthcare Act (ACA/Obamacare), your health insurance company is required to process your emergency visit at in-network benefit levels.