What is a Surprise Medical Bill?
Don’t Worry, We Got Rid of Them!
Few things are as unpleasant as having an accident that lands you in the ER. The one exception might be getting hit with an unexpected or surpise medical bill.
But why are you getting a surprise medical bill if you are insured?
Here is What Happens
When you visit an emergency room, regardless of whether it is in-network or not; you may be treated by physicians and other medical staff that may not be part of your insurance plan network.
When this happens, the insurance companies won’t cover the full amount, and you will receive a bill saying you owe the out-of-network provider money. These bills are called balance bills and are commonly referred to as surprise medical bills.
What is Balance Billing?
If the emergency room, and doctor that treated you are both in-network, then you will only need to pay for what is negotiated in your plan, usually this involves:
- Copay fees
- Co-insurance amounts
However, if the ER or the doctor is an out-of-network provider, you will receive a balance bill, which is the difference between what the doctor charged and what the insurance company paid.
Know Where to Go in Case of an Emergency.
What Can You Do?
During a medical emergency crisis, nobody has the time to check if a doctor is part of their insurance network.
But fear of not being able to pay for healthcare should never stop you from getting it.
Therefore, in case of an emergency, come to the nearest Altus Emergency Centers immediately. Let us save your life first, and we will resolve the financial part later.
When you receive a balance bill or in other words a surprise medical bill, here are the steps you should follow:
1. Always Request an Itemized Invoice
Texas law requires providers to present an itemized bill upon request. Some providers will send it automatically, but if you don’t get it, ask for it!
Reviewing your bill could help reduce the amount owed in two ways:
- You can verify there are no duplicate charges
- You can confirm you are only being charged for procedures, tests, and treatments you received.
Billing departments handle vast amounts of data every day. So, it’s possible for some unintended errors to occur. Carefully reviewing your balance bill is the best way to avoid overcharges.
2. Call Patient Advocate
If you received a balance bill from us, the first thing you should do is contact our Patient Advocate.
Our staff is available to answer any questions and address any concerns you have regarding your bill.
Additionally, our Patient Advocate may be able to negotiate rates with insurance companies to help lower your bill.
We can even offer financial aid or customize a payment plan that works for you.
Surprise Medical Bills May Soon be a Thing of the Past in Texas
Earlier this month, in a unanimous vote, the Texas House approved Senate Bill 1264.
When signed into law, SB 1264 will prohibit out-of-network providers from invoicing patients for their services directly.
Instead, the law would allow providers and insurers to negotiate with one another to secure payment. The legislation also creates state regulatory authority over that arbitration process.
What this means for you as a Consumer
This is excellent news for you as a consumer!
This Senate Bill will give us more leeway to push insurance companies to pay fair prices for the services provided without having to burden you.
Altus Emergency Centers Goes the Extra Mile
In case you haven’t heard the news, at Altus Emergency we directly control physician billing to ensure you superior service.
Since June 2019, all patients are treated exclusively by our in-house local doctors.
Additionally, this means we control the entire billing process so you will never receive a surprise medical bill from us. Physician services will still be billed separately for transparency purposes.
What Does that Mean to You?
- We hire local doctors. Therefore, you can expect to see a friendly and familiar face every time you visit us.
- Better Quality Control & Greater Accountability
- More Qualified Physicians. We hold our physicians to a higher standard than that required by the State Board. Visit our Altus Physicians Group page for more information.
- We control billing in house. No Balance or Surprise Billing
- Transparency. Physician bills will remain separate to maintain transparency. You will be able to see and review the breakdown of the costs.
- Local Billing. Bills will come from our Regional office in Southeast Texas
At Altus Emergency Centers, we are always looking out for your health and your finances. Contact our Patient Advocate if you have any questions or concerns with your bill.
Our Promise is to Always Help Find the Best Solutions in Benefit of our Patients from the time you walk-in without having to wait in line and when you are personally assisted with the billing process. We are here to help you get well and stay well!