Thank you for choosing Coppell ER 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 Coppell ER 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 hospital is out-of-network for all benefit plans.

Hospital Notice Required by HB 2041

The facility is licensed as a Hospital under the provisions of Chapter 241, Health and Safety Code, and the Hospital Licensing Rules.

The facility charges rates comparable to other hospitals and may charge a facility fee for emergency room services.

The facility or physician providing services at the facility may be out-of-network with the patient’s health plan.

A physician(s) providing medical care at the facility may bill separately from the facility for the medical care provided to a patient.

The hospital is out-of-network for all benefit plans.

El hospital está fuera de la red para todos los planes de beneficios.

Aviso hospitalario requerido por HB 2041

La instalación tiene licencia como Hospital bajo las disposiciones del Capítulo 241, el Código de Salud y Seguridad, y las Reglas de Licencias Hospitalarias.

La instalación cobra tarifas comparables a otros hospitales y puede cobrar una tarifa de instalación por los servicios de sala de emergencias.

El centro o médico que presta servicios en el centro puede estar fuera de la red con el plan de salud del paciente.

Un médico que proporciona atención médica en el centro puede facturar por separado del centro para la atención médica proporcionada a un paciente.

El hospital está fuera de la red para todos los planes de beneficios.

Where can I learn more about the No Surprises Act?

Visit CMS.gov/nosurprises, or call the Help Desk at 1-800-985-3059 for more information.

What if I have questions regarding a bill?

Contact the Patient Advocacy Department of Tyvan,LLC at (713) 357-2535, Monday – Friday from 7:30 – 4:30 CST.

COPPELL’S BILLING POLICY

Coppell ER accepts private insurance plans. We also accept out-of-pocket payment in the form of cash, checks or credit cards. Your ER co-pay will be collected at the time of your visit. We will then bill your insurance company for the policy’s emergency room benefits. There will be two different claims mailed to your insurance company: the facility bill and the physician bill. If you have any questions concerning your bill please contact our Billing Department, Tyvan Billing at 713-357-2535.

INSURANCE BENEFITS

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.

Coppell ER is classified as out-of-network with many insurance companies; however, West Plano ER does honor all in-network deductibles and benefits.

WHAT IS WORKERS’ COMPENSATION?

Workers’ compensation is a state-funded insurance program that gives covered employees income and medical benefits if they’re injured while working. Texas employers may choose to provide their employees with this coverage. Most employers will inform you as to whether or not you’re covered under this state plan.

Workers’ compensation pays medical bills and is covered underneath the Texas Workers’ Compensation Act.

For more information on workers’ compensation, visit this page.

If you’d like to file or dispute a claim, call 800-252-7031, option 1, to speak with a representative with the Texas Department of Insurance.

ARE WE IN-NETWORK?

For all cases deemed emergent, Texas 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 Texas empowers patients to use a standard called the prudent layperson standard when determining what constitutes as an emergency.

If your insurance provider is refusing to reimburse you for your emergency room visit, you can file a complaint with the Texas Department of Insurance (TlDI). For more information about this process and the Texas Department of Insurance visit http://www.tdi.state.tx.us.

WHY ARE SENATE BILL 425 AND HOUSE BILL 3276 SO IMPORTANT TO ME?

According to guidelines set by the state of Texas, all freestanding ERs are required to post the notice below at their facility and website:

• The facility is a freestanding emergency medical care facility;

• The facility charges rates comparable to a hospital emergency room, and may charge a facility fee;

• A facility or a physician providing medical care at the facility may not be a participating provider in the patient’s health benefit plan provider network;

• A physician providing medical care at the facility may bill separately from the facility for the medical care provided to a patient; and.

•This facility is not a participating provider in any health benefit plan provider network. However, by state law your health insurance company is required to process your ER visit at in-network benefit levels.