At the time of service, your ER co-pay was collected. We then filed with your insurance company for your ER benefits. The balance due represents your deductible, coinsurance, and other non-covered services.
A deductible is the amount you must pay out-of-pocket for expenses before your insurance company will begin to cover your medical bills. Typically, the deductible starts over at the beginning of the calendar year and each family member must meet his or her own deductible.
Texas Insurance LAW guarantees that all fully-funded medical insurance plans must pay for ALL emergency medical claims at the in-network level regardless of network status. This means that your visit will be processed under your in-network benefits. If your insurance company does not process it correctly the first time, our billing company will work on your behalf to correct the insurance company’s error, and get your claim processed in-network under your emergency room benefits. Quite simply it is a violation of the law for your insurance company to refuse to pay in-network for an emergency visit at a licensed ER such as Sublime Care ER. If you need assistance, please don’t hesitate to contact our billing company, they are here to help.
Be familiar with your benefits. Take the time to review your insurance policy. Find out if you have deductibles, coinsurance, or anything else that may be your responsibility. This knowledge will help you make educated decisions in seeking medical care.
Chargemaster is a comprehensive list of charges for every inpatient and outpatient service provided by Sublime Care ER – each test, exam, surgery or other procedures, room charges, etc. In other words, it is the starting point from which the price that is ultimately paid is determined.