Insurance Info

Thank you for choosing Village Emergency Centers for your emergency medical care. We understand that the ER billing process can sometimes be confusing or overwhelming. To better serve you, we want to make billing simple and transparent. Your Village Emergency Centers bill may be different from other medical bills you have received from hospitals or physicians. It’s important to note that each Village Emergency Centers is a state-licensed, fully functional emergency room.

The information on this page is designed to answer any questions you may have about how health insurance is handled at Village Emergency Centers. If you have additional questions, please don’t hesitate to call our no-worries billing hotline at 713-526-2330.

For more information on billing, please read our billing manifesto.

 

Read our billing process.

Your emergency room co-pay will be collected at the time of your ER visit. We will bill your insurance provider for your emergency room benefits. There will be two claims mailed to your insurance provider: one for the facility and another for the physician. There will not be separate fees for radiology, pathology or cardiology “over-reads” or interpretations as is seen with hospital-based ERs. These charges are included within the facility portion of the bill.

In order to treat emergency conditions effectively, ERs must diligently prepare. This preparation is much higher than what is traditionally seen at other medical facilities. The facility fee that is charged by the ER helps to offset the ongoing expenses related to maintaining this level of preparation. These costs are incurred in an attempt to provide you with the best in emergency care.

The facility fee is calculated based on a point system. This system is based on procedures performed, patient acuity level, and level of liability potential. If you have any questions regarding your billing and insurance, call our no-worries billing hotline at 713-526-2330. We will work closely with you to resolve any issues and look forward to serving you in the near future.

 

What insurance carriers does Village Emergency Centers accept?

Village Emergency Centers accepts all private health insurance, including providers such as Blue Cross Blue Shield, Humana, Aetna, UnitedHealth, and many others. If you have health insurance, you will receive an explanation of benefits (EOB) from your insurance company in the mail. Taking the time to become familiar with your benefits will help you make the best decisions possible when seeking medical care. It’s important to note that the EOB is not a bill.


Understand your insurance benefits.

If you are insured, you will receive an explanation of benefits (EOB) from your insurance provider in the mail. This will explain our charges. The EOB is not a bill. Please note that there may be additional charges related to your visit depending on your insurance plan. For most insurance providers, we are considered out-of-network. However, we honor all in-network deductibles and benefits. We will contact your insurance provider and notify them that we are honoring your in-network benefits. By reviewing your EOB from your insurance company, you can make the process simpler by knowing your benefits. Reviewing your insurance policy will allow you to determine if you have deductibles, co-insurance, or anything else that you may be responsible for. This will allow you to make an educated decision when seeking medical treatment.

 

Does Village Emergency Centers accept Medicare and Medicaid?

Unfortunately, free-standing emergency rooms such as Village Emergency Centers are presently prohibited by federal law from accepting Medicare, Medicaid, TriCare, CHIPS, Texas Star, VA, Moina, and Community Health. This is a government mandate and not a choice we have made. However, we will never refuse treatment in life-threatening situations, regardless of the patient’s ability to pay.

 

Will I pay in-network or out-of-network rates at Village Emergency Centers?

Texas insurance law requires that all fully-funded medical insurance plans treat every emergency claim as in-network. The burden of proof, however, falls on the emergency room. If Village Emergency Centers does not classify your treatment as a “medical emergency,” your insurance company may not consider it in-network. In that case, many plans will pay 80 percent of your in-network costs and 50 percent of your out-of-network costs.

If your health insurance company attempts to treat your classified medical emergency as out-of-network, you can consider it a violation of the law and take action by contacting your billing company or your insurance agent.

 

What am I expected to pay at the time of service?

At the time of service, you are expected to furnish your copay. Your deductible, along with co-insurance and other services that were not covered by your insurance, will be billed to you as your “balance due,” which you will receive a few days or weeks after your treatment. Your deductible usually renews every calendar year and signifies the amount you must pay before your insurance takes over your medical bills. As a result, your bill might be larger than you expect if you have a high deductible or have not had any health expenses for the year.


Yes! Texas law dictates that you can go to any federally-sanctioned emergency room, including Village Emergency Centers, and receive treatment. If your condition is deemed an emergency, uninsured patients will not be turned away from Village Emergency Centers, and typically we will work out payment plans to accommodate uninsured patients.

 

Senate Bill 425 And House Bill 3276

NOTICE OF FEES – Village Emergency Centers, are in compliance with Senate Bill 425, effective January 1, 2016, and modified by House Bill 3276, effective September 1, 2017, please notice the following:

(1)  Every Village Emergency Center (River Oaks, Katy and Clear Creek ERs) is a freestanding medical care facility;

(2) Our rates are comparable to a hospital emergency room and we may charge a facility fee;

(3) Our physicians may or may not be a participating provider in your health plan provider network; you may need to check with your healthcare benefit provider;

(4) Our facility is not a participating provider in any health benefit plan provider network. However, by state law your health insurance company is required to process your emergency visit at in network benefit levels;

(5) Your physician providing medical care today may bill separately from the facility for the medical care provided to you.

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