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
REQUIRED POSTING – BILLING PRACTICE NOTIFICATION
• Frisco ER is an EMERGENCY ROOM facility.
• This facility charges rates comparable to a hospital emergency department including a facility fee. Charge Master
• This facility or a physician providing medical care in this facility may be an “Out-of-Network” provider for the patient’s health benefit plan provider network.
• Federal and state laws mandate insurance carriers to reimburse emergency services regardless of whether the covered individual is treated at an “in-network” or “Out-of-Network” emergency room. This applies to the emergency services provided by this facility as well.
• This facility does not participate in Medicare, Medicaid, or Tricare plans.
• A physician providing medical care at this facility may bill separately from the facility for the medical care provided to a patient.
• A physician providing medical care at this facility may participate in Medicare and may bill Medicare for professional service rendered.
The Department of State Health Services, Patient Quality Care Unit-Health Facility Compliance is the responsible agency for facility complaints that are unresolved by Frisco ER.
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
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)
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. Frisco ER Covid-19
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.
Pursuant to section 6001 of the Families First Coronavirus Response Act (the “FFCRA”) as amended by Sections 3201 and 3202 of the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) specifically as the foregoing relate to the provision and reimbursement of orders for and or administration of SARS-CoV-2 or COVID-19 (collectively, “COVID-19) in vitro diagnostic tests (including serological tests used to detect COVID-19 antibodies) as well as the provision and reimbursement of items and services furnished to individuals during visits that result in an order for, or administration of a COVID-19 in vitro diagnostic test(s) and or the provision and reimbursement of services related to the evaluation of such individuals by the attending healthcare provider for purposes of determining the need for the product or service in question, the following are the lists by provider of CPT codes and associated cash prices required by section 3202 (b) of the CARES Act related to the foregoing COVID-19 in vitro diagnostic testing services as well as said related items and services