Understanding your Medical Bill

Thank you for choosing Austin Emergency Center for your emergency healthcare needs. We understand that you may find medical billing to be a complicated process. At Austin Emergency Center, we strive to be fair and transparent with your medical bill. We want to help you understand the bills you receive from us, which may be different from medical bills you’ve received from hospitals or physicians.

Austin Emergency Center is a licensed freestanding emergency center. We function just like a hospital-based emergency room. According to Texas Guidelines, all insurance carriers are required to pay in-network benefits for any member needing emergency medical treatment. In fact, the law states that you must be reimbursed by your insurance carrier for your emergency room visit. Texas law requires that your insurance carrier pay for your emergency care, whether the emergency room is in-network or out of network. The state of Texas empowers you to use a prudent layperson standard when considering what constitutes an emergency.

Insurance Benefits

If you have insurance, you will receive an explanation of benefit (EOB) from your insurance company in the mail explaining our charges, Please note this is not a bill. Depending on your insurance plan, you may have a deductible and or co-insurance . We are an out of network facility; however your insurance company is OBLIGATED to process your emergency room visit as in network due to State and Federal Law.

You can make the process easier by reviewing the EOB from your insurance company to become familiar with your benefits. By taking the time to review your insurance policy, you will find out if you have deductibles, co-insurance, or anything else that might fall under your responsibility. This will help you make educated decisions when seeking medical care.

Our Billing Policy

At the time of your visit, your emergency room co-pay will be collected, and we will bill your insurance carrier for your policy’s emergency room benefits.

Two separate claims will be mailed to your insurance company: one for the facility and one for the physician. Your insurance company will not be charged separately for radiology, pathology, or cardiology over-reads, as is the case with hospital-based ERs. Instead, these charges are included in your facility bill.

Emergency rooms must maintain an extremely high level of preparedness in order to effectively treat emergency medical conditions. This level of preparedness is considerably higher than at other, more traditional medical facilities. Emergency rooms charge a facility fee for each patient visit to help offset the recurring costs associated with maintaining this high level of preparedness. This is done to ensure

you have access to an environment that provides the best in emergency care. The facility fee is a charge that is calculated on a point system, which is based on procedures performed, patient acuity, potential liability, and the complexity of the physician/patient interaction.

If you have any questions regarding your bill, please contact our billing office at 713-357-2535. We will work with you quickly to resolve any differences.

Looking for an additional resource for understanding free standing emergency centers? Click on the following link to read more:
BlueCross BlueShield of Texas Medical Emergency Location Guide

We look forward to serving you in the future.