Person completing paperwork at an emergency medical center.

Decoding Health Insurance at the Emergency Room

Navigating through the labyrinth of health insurance can be complex, especially when you're dealing with an emergency. At PrimeCare Emergency Center in Arlington, TX, we understand the importance of focusing on recovery rather than paperwork during such challenging times. That's why we've created this guide to help you understand how health insurance works at our facility.

Understanding Our Services and Rates

PrimeCare Emergency Center is a freestanding medical care facility offering services comparable to a hospital emergency room. We strive to provide quality, personalized care while maintaining competitive rates. However, it's important to note that our physicians may or may not be a participating provider in your health plan network.

While we are not a participating provider in any health benefit plan provider network, state law mandates your health insurance company to process your emergency visit at in-network benefit levels. This means that even as out-of-network providers, your insurance company is responsible for paying your in-network emergency services once you've covered your deductibles and co-payments.

Billing and Payments

At PrimeCare, the physician providing medical care may bill separately from the facility for the medical care provided. Patients/guarantors are required to pay all charges associated with the services available at our center. It's essential to understand that insurance claims are usually filed within 30 days of a patient's visit. If your insurance company hasn't paid the claim within 90 days, you, as the patient/guarantor, are required to pay all outstanding balances.

For insured patients, we file an itemized claim on your behalf. Once the claim has been processed successfully, your insurance company will provide an itemized Explanation of Benefits. For patients who paid in cash or are uninsured, we will provide an itemized statement of charges.

Understanding Pricing Information

We aim to maintain transparent communication about the costs involved. Nevertheless, we make no guarantees regarding the accuracy of the pricing information provided on our website. The pricing information is strictly an estimate and may differ substantially from your final bill for services rendered.

In compliance with Texas House Bill 2041, we provide a complete list of charges for all services and items at our facility. This allows you to understand the potential costs involved in your care.

Patient-Catered Emergency Care in Arlington

At PrimeCare Emergency Center, we are committed to delivering professional, compassionate care while helping you navigate the complexities of health insurance. We hope this guide has shed some light on the process and alleviated some of your concerns. Remember, our team is always here to support you through your health journey.

Please note that this blog post is intended to be informative and does not replace professional advice. Always consult with your insurance provider or a financial advisor for personalized guidance based on your specific circumstances.

Remember, your health comes first. Trust in our team to provide quality, personalized care when you need it most. Call (682) 253-6655 or stop by our emergency center today.