ATTENTION PATIENTS

• This facility charges rates comparable to a hospital emergency department including a facility fee
• The physician may bill separately from the facility.
• The facility and facility-based physicians may not be a participating provider in an individual’s health plan network.
• This facility by ER NEAR ME is currently an out-of-network provider for all insurance carriers.
• 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 our facility as well.
• This facility by ER NEAR ME is not a participating Medicare, Medicaid, or Tricare facility.

• If your physician determines that you do not have an Emergency Medical Condition and you choose to receive Non-Emergency Care at this facility, you will be responsible for payment of the services rendered.
• The physician services provided by ER NEAR ME will not be included with the facility billing statement.
• The Department of State Health Services, Patient Quality Care Unit-Health Facility Compliance is the responsible agency for facility complaints that are unresolved by ER NEAR ME. The disclosure will include the 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
Phone: (888) 973-0022