Transforming Healthcare
Medicine can be confusing. Paying for healthcare doesn’t have to be.
To better serve you, we want to make the billing process simple and transparent. We want to help you understand your bill.
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.
Click the links below to learn more:
Visit CMS.gov/nosurprises, or call the Help Desk at 1-800-985-3059 for more information.
Contact the Patient Advocacy Department at (713) 357-2535, Monday – Friday from 7:30 – 4:30 CST.
For your emergency department visit, your ER co-pay will be collected at the time of your visit. We will bill your insurance company per the policy’s emergency room benefits. There will be two different claims mailed to your insurance company: the facility bill and the professional bill.
If you have health insurance, you will receive an EOB (explanation of benefits) from your insurance company in the mail. Taking the time to be familiar with your benefits will help you make the best decisions when seeking medical care. It is important to note that the EOB is not a bill.
We never balance bill, which means you never pay more than you should for your healthcare.
East Valley ER – Chandler accepts private insurance plans, such as employer-based plans and marketplace commercial plans. We also have transparent out-of-pocket payment options, with the ability to pay in the form of cash, checks, or credit cards.
We are now accepting Medicare.
If you have questions about a specific insurance carrier, contact us at (480) 284-5867.
East Valley ER – Chandler is classified as out-of-network with some insurance companies; however, we honor all in-network deductibles and benefits.
For all cases deemed emergent, state law requires your insurance company to pay for your emergency care, even if the emergency room is classified as out-of-network. The state of Arizona empowers patients to use a standard called the prudent layperson standard when determining what constitutes as an emergency.
East Valley ER – Chandler accepts “in-network” benefits even if your insurance company is “out of network”. We honor all in-network deductibles and benefits.
Under Arizona law, it is mandatory for employers to secure workers’ compensation insurance. Workers’ compensation is a “no fault” system in which an injured employee is entitled to receive benefits for an industrial industry, no matter who caused the job-related accident. Workers’ compensation pays medical bills and is covered under the Arizona Workers’ Compensation Law.
Visit the Industrial Commission of Arizona’s website for more information on workers’ compensation.
An injured worker must file a workers’ compensation claim in writing with the Commission within one year after the injury occurred.
We want to help you understand your bill. It’s important to note that East Valley ER – Chandler is a freestanding emergency center, so your bill may be different from other medical bills you may have received from hospitals or physicians.
East Valley ER – Chandler has partnered with Tyvan, LLC, a medical billing services company, to provide a 24/7, simple and secure way for you to manage your medical bills. If you have any questions concerning your bill please contact our billing department at (713) 357-2535.
At any point, if you would like to speak to our Billing Department, please call (713) 357-2535.
NOTICE: East Valley ER – Chandler previously provided services under the name Phoenix ER.
