Billing and Insurance

Guidelines for Texas Emergency Rooms

Emergency care is defined as health care services provided in a freestanding emergency medical care facility to evaluate and stabilize a medical condition of recent onset and severity, including severe pain, that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that the person’s condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in placing the person’s health in serious jeopardy. You can find our required legal posting here.

Your insurance provider is required to reimburse you for emergency treatment. If your insurance company refuses to reimburse you for your emergency room visit, you may file an official complaint with the Texas Department of Insurance. For additional info about the Texas Department of Insurance, go to http://www.tdi.state.tx.us.

All freestanding emergency centers shall provide, without regard to the individual’s ability to pay, an appropriate medical screening, examination, and stabilization within the facility’s capability to determine whether an emergency medical condition exists and any necessary stabilizing treatment.

Texas House Bill 2041

This facility is a freestanding emergency medical care facility. The facility charges rates comparable to a hospital emergency room and may charge a facility fee. A facility or a physician providing medical care at the facility may be an out-of-network provider for the patient’s health benefit plan provider network. A physician providing medical care at the facility may bill separately from the facility for the medical care provided to a patient. This facility is an out-of-network provider for all health benefit plans.

Charge Master

Department’s contact information: Department of State Health Services, Patient Quality Care Unit - Health Facility Compliance P.O. Box 149347, Mail Code 1979, Austin, Texas 78714-9347. Telephone: (888) 973-0022.

Requirements Imposed by Families First Coronavirus Relief Act

Insured Patients

A group health plan, and a health insurance issuer offering group or individual health insurance coverage including a grandfathered health plan as defined in section 1251(e) of the Patient Protection and Affordable Care Act shall provide coverage, and shall not impose any cost-sharing including deductibles, copayments, and coinsurance.

Uninsured Patients

Public health and social services emergency fund reimbursement for testing of uninsured individuals.

Cares Act and Covid-19 Testing

Providers must clearly publicize the cash price of the COVID-19 test on the website or be subject to civil monetary penalties up to $300 per day while the violation is ongoing.

We are an emergency room facility and, per our mission, we are a comprehensive emergency medical facility. Because of the type of facility and services that we offer, we do not offer standalone testing for COVID-19 or testing of asymptomatic patients. Our pricing of a comprehensive treatment plan may include Covid-19 testing, of which the cost for the test, not including any and all other necessary testing and/or services, is charged at $150 for a Covid-19 Rapid, point-of-care diagnostic test and $450 for a Covid-19 PCR swab test. The final price may include the additional cost of an emergency room physician’s physical assessment. Patient responsibility will be discussed prior to any treatment.

Frequently Asked Question

In case you had any concerns, here are some frequently asked questions and answers to clear things up.

Q1 What Insurances are accepted at Castle Hills ER ?

We process all commercial insurances however, currently we do not take Medicare, Medicaid, or Tricare.

Q2. WHAT IS AN EOB?

EOB is, an Explanation of Benefits (EOB) it is NOT your bill. EOBs can often be confusing and may appear quite distinct from the bill you may receive. For inquiries regarding your actual bill, please reach out to our billing department.

Q3. WHAT IS CASH PAY/SELF-PAY?

After physician evaluation and consultation of the patient, we will discuss the physician recommended treatment plan and associated costs to ensure you are fully informed and comfortable with the expenses before the treatment begins. Our basic cash pay/self-pay visit fee starts at $200, with potential increase depending on the required tests and treatments.

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