Comprehensive Medical Billing Solutions

We understand that the receipt of medical bills for healthcare services can be confusing and at times intimidating. Please know that we are here to help with the reconciliation of your emergency room bill. Below is a list of frequently asked questions that you may find helpful to understand the medical bills you have received for these services. Please note that this list is by no means all inclusive to every situation. Should you have any further questions related to your emergency room bill, our Customer Service Department will be more than happy to assist you. Please feel free to contact us by clicking here.

Each physician who provides professional services will send you a separate bill from his or her office. These physicians may include specialists in anesthesiology, cardiology, emergency medicine, nuclear medicine, pathology, or radiology.

The bill you have recently received from this physician group is for the professional services rendered in the Emergency Department. You or your insurance company will be responsible for paying this bill as well as your hospital bill.

The cost of providing services in the Emergency Department is usually greater than non-hospital based facilities. This is because of the need for highly specialized medical staff and equipment as well as the costs associated with the facility remaining open 24 hours a day 365 days a year.

The physician’s fee is not solely based on the amount of time spent directly with the patient, but also the behind the scenes services such as consulting with other physicians and medical staff. Additional items that affect charges include ordering and evaluating tests, overall supervision of care, documenting the medical record, as well as quality assurance.

This describes the service rendered to the patient as documented by the emergency physician in the medical record. The service includes, valuation, treatment, consultations with other healthcare professionals, ordering and evaluation diagnostic tests and the overall supervision of care. Evaluation and Management services include a wide variation of skill, effort, time, responsibility, and medical knowledge required for the prevention or diagnosis and treatment of illness or injury of the patient. Our physicians and coding staff are professionally trained to determine the appropriate Evaluation and Management services according to guidelines provided by the American Medical Association.

If you feel you were charged for something that you did not receive, please contact our Customer Service Department. If you have any questions concerning tests or procedures you received, please contact your physician.

The provider who treated you is a licensed healthcare provider and provided services under the direct supervision of the emergency physician on duty at the time. The emergency physician supervised and authorized all services rendered to you and therefore accepted responsibility for your care.

The physician group will gladly file your bill with any insurance companies you have authorized at the hospital when you were treated. The hospital forwards this billing information to our attention so that it can be included when the account is billed. If you provided insurance information at the hospital that was not billed by the physician group, please contact our Customer Service Department at 866.321.8433 to update your account.

After your insurance company has paid its portion of your bill, we will send you a statement of account. This statement will indicate payments and adjustments that have been posted to your account as well as any balance you are required to pay. You may also receive an explanation of benefits from your insurance company.

We do not have access to your insurance policy and are generally unable to give you detailed information such as this. If we have received any such information from your insurance company, we’ll be glad to share it with you. However, for answers to any questions about insurance payments, deductibles, or co-payments, you generally need to check with your insurance company.

The emergency physician provided the interpretation of the X-ray used in the diagnosis and treatment of the patient. In some cases the Radiologists will provide a quality assurance reading of the X-ray and submit a final report.

We regret your loss and understand this is a difficult time. While we wish there were an easier way to resolve the outstanding debt, the estate of the patient/responsible party is still responsible for the bill. Any insurance information we have received will be used for reimbursement on the account.

You received this bill based on information that was provided to us from the hospital. If you feel that this bill might be the result of the theft of your identity, please contact our Customer Service Department to verify your information. In addition to contacting us, it is important that you contact the hospital billing department to notify them of this situation. Should any police reports be filed pertaining to identity theft, please fax us a copy to have on file pertaining to your account.

We have filed your account with your insurance company for payment. After a reasonable amount of time, they have yet to respond on your claim. Please contact your insurance carrier to check the status of your claim.

We file insurance claims as a courtesy to you, the patient. Insurance companies deny claims on occasion for numerous reasons. Most often they need information from the patient. Since you and the insurance company are the only two parties that have the terms of your policy, payment disputes are generally much easier to handle by you contacting the insurance carrier directly.

Although a particular insurance plan may be in network or participate with a hospital, not all physicians that work at the hospital are in network. Many, if not most physicians working at the hospital, are independent contractors rather than employees of the hospital and choose the plans they participate with. While it is typically the goal of the emergency physicians to participate with all plans the hospital has contracted with, not all insurance companies offer reimbursement rates that are acceptable. We would encourage you to contact your insurance plan and have them reconsider this claim for additional payment since your services were an emergency.

Before you contact your insurance plan, have available your insurance card, date of service, provider name, original billed amount, patient name and claim number if possible. Obtain satisfactory status of account. If paid, ask when and to whom. Note this information and who you talked to at the insurance company. If the bill has not been paid, find out the when the anticipated time frame of payment is, and ask if they need anything from you. If the bill isn’t paid in the stated time frame, follow-up with the insurance company again and, if necessary, request to speak with a supervisor.

The physician group determines the fees for their services, not the insurance company. Each insurance company may determine what it considers “usual and customary” and will vary depending on the company, the insured’s policy, and the geographic location of the insured. If the physicians do not participate with your insurance, then you are responsible for any balance not paid by your plan.

If the physician group who treated you in the emergency room does not participate with your insurance plan, this adjustment will not be applied to your account. This balance is your responsibility. If you feel that your insurance company processed your claim incorrectly, please contact your plan directly.

In some cases, monthly payments are acceptable, but they must be based on an approved plan. We will be glad to discuss the arrangements with you, so that the plan is mutually satisfactory for all involved.

Yes. If you wish to pay your balance online, please click here to make a secure online payment to your account balance using Visa, Mastercard or Discover.

When processing credit card payments, the payment must first be authorized to verify the account is active. When the card is processed a hold is placed for the amount on the account to ensure funds are available. For most accounts, this generally takes 24-48 hours before a confirmation or denial transaction is received and posted to the credit card account. If it is necessary to run a card twice, it will initially show up twice on your account until the transactions are confirmed. If you still have concerns, please review the details with your bank and they should be able to clarify any discrepancy. If further assistance is needed, click here to contact our Customer Service Department

The medical record that we have on file only pertains to the Emergency Room record. Any request for a copy of medical records should be directed to the hospital or medical facility so that a full and complete copy of the medical record may be obtained.

We are committed to the prompt, complete, and accurate processing of patient accounts with credit balances and related refunds. If it is determined that an overpayment has been made on your account, the amount of the overpayment will generally be processed and refunded within 60 days after it is identified.

Yes, if your account goes unattended for an unreasonable amount of time, it will be referred to an outside collection agency. If it is not resolved with the collection agency, they will report it to a credit bureau.

Although we wish we could help you, if your account has already been sent to a collection agency all questions should be directed to the agency that possesses your account.

We are sorry to hear that you may not have been fully satisfied with the services that you received during your recent visit. If you would like to have your complaint reviewed, please forward your complaint in writing to our attention. This can be done by utilizing our website or by mailing your complaint on paper to the mailing address on your statement. During this review process, your account will be placed on hold for billing until a determination has been made on your account.

We ensure your privacy and confidentiality by following state and federal privacy and confidentiality laws, as well as adhering to our own organizational privacy and confidentiality policies. In order to receive payment for treatment and services you received in the Emergency Room, we may disclose your health information to others. For example, a bill may be sent to you or a third-party payor, such as an insurance company or health plan.