Frequently Asked Questions

FAQs – Understanding the ER bill

Do you have a question for us?  Don’t hesitate to contact us via phone or email. We look forward to answering your queries.

What is the billing process at Exceptional ER?

Exceptional ER has a simple and flexible billing procedure that is quite similar to  a conventional hospital based ER. At the time of service, we collect the copays and if there’s any previous deductible balance or any co-insurance payments are due, patients are required to pay those off.

Patients are billed for the services rendered at the ER and a copy of the bill is mailed to them. If you have any questions, please call us at Exceptional ER.

What if Exceptional ER is not in my insurance network?

By law, patients are reimbursed by their insurance carriers for their ER visits.
Texas Guidelines require all insurance carriers to pay in-network benefits for any member availing emergency medical treatment.

Texas law further requires insurance carriers to pay for a patient’s emergency care, whether the emergency room is “in network” or “out of network.” The state of Texas empowers patients to use “a prudent layperson standard” in deciding what constitutes an emergency.

What if a patient is facing trouble with the insurance company?

State law mandates insurance carriers to reimburse patients for their ER visits. In case an insurance company  doesn’t agree to cover your emergency room visit, patients can exercise their right to file a grievance with the Texas Department of Insurance.

To learn more about the Texas Department of Insurance, please refer to their website: http://www.tdi.state.tx.us

Who will answer queries about your bill?

Most patients believe medical billing is acomplex and time consuming process. At Exceptional ER, the billing process is easy and transparent. If patients have any questions regarding billing or insurance, please contact us at info@exceptionaler.com. We will do our best to answer your questions.

What is a patient advocate and how can you contact them?

At Exceptional ER, we provide a patient advocate to our patients; the advocate provides guidance to patients and helps them understand the ER Bill and effectively serves as a liaison between the ER facility and the patient.

What insurances does Exceptional ER accept?

Exceptional ER accepts all major private insurance plans like Aetna, Blue Cross/Blue Shield, United Healthcare, Humana, etc.

Unfortunately, we do not accept Medicaid or Medicare. If you do not have insurance, we can work with you to devise a cash fee schedule so that you can cover your visit. We assure that there are no hidden fees or charges.

I received an Explanation of Benefits (EOB) after my visit to the ER. Is that my bill?

After a visit to the emergency room, patients receive an Explanation of Benefits (EOB). The EOB is NOT your bill; it is a statement from your insurance company that is sent to you and to Exceptional ER to explain the medical services that were covered and paid for.

What are my payment options if I cannot pay my balance in full?

In situations, where a patient is incapable of paying the balance in full, multiple payment options can be used through Exceptional ER’s billing office.

A down payment followed by successive monthly payments can be made to cover the entire bill progressively. For more information, please contact us at info@www.eer24.com

FAQs – What patients should know

What is the difference between a freestanding emergency room like Exceptional ER and a hospital’s ER?

A freestanding emergency room is operationally different from a hospital emergency room which is actually attached to a hospital.

Essentially, Exceptional ER operates 24/7 and promises and provides exactly same level of service and quality care in all emergency situations, just like a hospital’s Emergency Room.

Freestanding ERs function autonomously; they are commonly positioned in nearby neighborhoods; offer flexible payment mechanisms and have much shorter waiting times than your conventional hospital ERs.

When should a patient visit Urgent ER? 

When a patient requires immediate medical attention and is suffering from a non-life-threatening condition, which does not necessitate a visit to the ER, it is recommended to visit an Urgent care or a PCP.

Nonetheless, if the patient is in a serious condition and in an emergency, he or she must be taken to a local ER, such as Exceptional ER.

Does Exceptional ER provide emergency care services to children? 

At Exceptional ER, we understand that medical emergency incidents are quite difficult and stressful for both parents and children. Our physicians and Emergency Care Staff are qualified and trained in pediatric emergency care to treat children aptly in the event of an emergency or illness.

Moreover, our ER facility is quite calm and less rushed than conventional emergency rooms. We assign special rooms for our child patients to ensure extra care for them.

How is Exceptional ER different from conventional Emergency Rooms?

Exceptional ER is your personal emergency room that is accessible for you round the clock just like traditional emergency rooms.

When you visit Exceptional ER, you would experience a calm and controlled environment and will be treated in a few minutes after you reach.  We also follow up with the primary care physician to ensure optimum treatment and communication between your care providers.

Long queues, waiting times and a rushed environment are clearly not a feature of our ER.

What insurance is accepted at Exceptional ER? 

Exceptional ER accepts all major private insurance plans like Aetna, Blue Cross/Blue Shield, United Healthcare, Humana, etc.

We also work on a cash fee schedule with those patients who do not have insurance, to help them cover their medical visit to the ER.

What if I need to stay at the hospital?

In certain circumstances, patients are required to stay at a hospital. At Exceptional ER, we keep patients under observation for a period of up to 23 Hours; after that we have signed agreements with nearby local healthcare providers to make sure that you are transferred to the hospital of your choice.

We also help our patients choose the hospital that’s best for them according to your medical condition.

What if you require additional care or surgery? 

At times, when patients need to undergo an in-depth procedure that can only be performed at a hospital, we assume the responsibility and take care everything for you.

Patients can decide to skip the visit to the hospital’s ER and be admitted to a room when they arrive. To ensure a smooth changeover, we even furnish patients with practitioner referrals.

LEARN ABOUT TEXAS SENATE BILL 425
Senate Bill 425 relates to healthcare and the fees charged by freestanding emergency centers. Exceptional ERs freestanding emergency centers offer instant medical care and charge rates that are similar to charges of hospital ERs, however we may charge separate facility fees.

In some cases, patients may need to be treated by physicians who are out of network and patients may be billed separately by the physician providing medical care.

Exceptional Emergency Center White Colored Logo

Harlingen | Fort Worth | Brownsville | Sachse | Dow Emergency – Livingston

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