Thank you for choosing Archview ER & Hospital for your emergency medical care. We understand that some patients may find the billing process confusing or overwhelming. To better serve you, we want to make the billing process simple and transparent. Your bill may be different from other medical bills you may have received from hospitals or physicians. It’s important to note that Archview ER & Hospital is a specialty-hospital.
In an effort to protect patients, the federal government issued the Federal No Surprises Act (NSA). The NSA addresses several different points. The most notable point is the NSA serves to prohibit surprise billing. A surprise medical bill is an unexpected bill, often for services received from a healthcare provider or facility, that a patient may not have known was out-of-network with their insurance until a bill is received. Simply stated, an out-of-network provider cannot send a bill to a patient for any amount outside of their yearly in-network deductible and co-insurance. This does not apply to amounts paid directly to patients by their insurance provider for services rendered rather than paid to the provider. In those cases, a patient may receive a bill for full charges until the insurance payment amount is provided or paid over to the appropriate facility by the patient.
The Federal No Surprises Act was issued after lawmakers passed a law to base emergency services payments on local median in-network rates, also known as QPAs, instead of usual and customary rates. The law enacted a system where insurers and providers negotiate the correct amount to be paid. Once in agreement, the bill can be settled through an independent dispute resolution process. Insurers must now disclose how they come to the QPA-median in-network price and if they down-coded the claim for any reason.
The No Surprises Act is a federal law that protects you from unexpected medical bills for emergency care. Even if the hospital or provider is out-of-network, your insurance must cover emergency services at the same rate as in-network care. You are only responsible for your usual copay, deductible, or coinsurance. This law helps make sure you aren’t charged more than expected for emergency medical care. Learn more about the No Surprises Act at CMS.gov/nosurprises, or call the Help Desk at 1-800-985-3059 for more information.
If you have questions about your bill, our Nutex Patient Advocacy team is here to help. Contact us at 713-357-2535 Monday through Friday, 7:30 am – 5:30 pm CST, or email patientadvocacy@nutexhealth.com.
At this time, Archview ER & Hospital is not contracted with any commercial insurance plans or governmental insurance programs. However, we can bill your commercial insurance for services provided. Your Emergency Room copay is due at the time of your visit. After your visit, your commercial insurance will receive two separate claims for services: one for hospital (institutional) services and one for physician (professional) services.
Your insurance company will send you an Explanation of Benefits (EOB) showing what they paid and what you may owe. Please note that an EOB is not a bill. If you have any questions about your charges, our Nutex Patient Advocacy Department is available to help. You can call (713) 357-2535 Monday through Friday, 7:30 am – 5:30 pm CST, or email patientadvocacy@nutexhealth.com.
For patients without insurance or those with governmental insurance, cash-pay discounts may be available. We accept cash, checks, all major credit cards, and CareCredit.
Archview ER & Hospital honors all commercial insurance plan’s in-network benefits, including copays, deductibles, and coinsurance, and we comply fully with the No Surprises Act. We are currently non-participating with Medicare, Medicaid, TRICARE, and the Department of Labor. Cash-pay discounts are available at the time of service for these non-participating governmental insurance plans.
Workers’ Compensation is an insurance program purchased by your employer that provides medical care and income benefits if you are injured at work. To confirm coverage, your employer’s Human Resources department can provide details. This helps ensure you don’t pay out-of-pocket for work-related care.
Please note that Archview ER & Hospital is unable to accept Department of Labor Workers’ Compensation at this time.
Archview ER & Hospital complies with EMTALA regulations and provides medical screening examinations to all patients, regardless of insurance status. While we are not currently contracted with commercial insurance plans, federal law requires insurers to cover emergency services at in-network rates when the visit is considered emergent. As a patient you are responsible for your Emergency Room copay, yearly deductible, and coinsurance per the benefit plan provided at the time of service. We comply with the federal No Surprises Act of 2022.
We are non-participating with Medicare, Medicaid, TRICARE, and the Department of Labor. Cash-pay discounts and payment options may be available for patients who obtain these insurance plans. Archview ER & Hospital offers CareCredit and qualified patients can receive quick approval and use it to pay for services.
Our standard charges and required price-transparency information are available on our website to help you understand potential costs. For questions, our Nutex Patient Advocacy team is available to assist. Call us at (713) 357-2535 Monday through Friday, 7:30 am – 5:30 pm CST, or email patientadvocacy@nutexhealth.com.
Emergency Room Billing Information Simplified
We understand that medical bills can be confusing, especially during an emergency. Below is a simple explanation of how Emergency Room billing works and what you may expect after your visit.
1. You Receive Care
- When you visit the Emergency Room, our medical team evaluates and treats your condition.
2. We Bill Your Insurance
- Our billing team sends two separate claims to your health insurance company for the services you received. One for the facility services and one for physician services.
3. Insurance Reviews the Claim
- Your insurance provider reviews the services and determines what they will pay based on your plan’s benefits.
4. Explanation of Benefits (EOB)
- Your insurance company will send you an Explanation of Benefits (EOB). This is not a bill.
- It shows:
- What services were billed
- What your insurance paid
- What amount may be your responsibility, such as Copay, Coinsurance and Deductible.
5. You May Receive a Billing Statement
- If there is a patient balance applied by your insurance such as Copay, Coinsurance, and Deductible, you will receive a statement showing the amount owed. Please be advised, this is not a balance bill.
Emergency Room care often involves multiple providers. Because of this, you may receive separate bills from: The hospital or facility & the emergency room physician.
Depending on your insurance plan, you may have some out-of-pocket costs.
- Copay: A fixed amount you pay for an Emergency Room visit, typically collected at the time of service in the Hospital.
- Deductible: The amount you must pay each year before your insurance begins paying for certain services.
- Coinsurance: A percentage of the cost you may be responsible for after your deductible is met.
- Out-of-Pocket Maximum: The most you will pay during your plan year for covered services.
Under the No Surprises Act, patients are protected from surprise medical bills for emergency services.
This means:
- You cannot be charged more than your in-network cost-sharing amount for emergent care.
- You will not be balanced billed for emergency services.
- Providers cannot bill you for the difference between what your insurance pays/allows and the total charge.
You are only responsible for your Emergency Room copay, deductible, or coinsurance according to your insurance benefit plan.
If you have questions about your Emergency Room bill, our billing team is happy to help explain your statement and review your account.
Please contact our billing office for assistance at (713) 357-2535 Monday – Friday 07:30 am – 5:30 pm CST.
