"We strive to provide a positive experience from the moment you check-in, all the way through the billing process."
We process all commercial insurances, but not Medicare, Medicaid (including ARKids) or TRICARE. Most importantly, no matter a patient's insurance status, all patients receive a basic medical exam by one of our Board-Certified Emergency Physicians. A cash-pay rate is available to those with Medicare, Medicaid, TRICARE, those with high deductibles plans and others who may not be covered or have insurance. Cash-pay rates may significantly reduce your out of pocket costs and will eliminate any need to wait for insurance authorization.
Did You Know?
Although we are out-of-network with some insurances, federal law requires your insurance provider to process your ER visit as in-network. We strive to provide a positive experience from the moment you check-in all the way through the billing process.
What To Expect
After your visit, your insurance provider will send you an explanation of benefits (EOB) explaining what your insurance has agreed to pay on your behalf. It is important to know that an EOB from your insurance company is not the same as a bill from Cabot Emergency Hospital. In almost all cases, you will not owe what your EOB indicates. Here are a few more good things to note:
- We're committed to finding a payment arrangement that works for your specific needs.
- Our patient advocate is available to discuss any questions or concerns Monday through Friday, 7:30am-4:30pm.
- Your insurance may send you a check for services rendered that you will then need to bring or send to CEH.
- Your claim may take longer than usual to resolve if we are required to appeal to your insurance company.
Patients are our priority. We will work on your behalf to resolve any billing issues that arise from your insurance provider for emergency services you receive. If your claim processed incorrectly, outside of your plan's network, please contact our patient advocate at (713) 357-2535 so we can help. To make a payment, click here.
Federal No Surprises Act (NSA)
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.