Concho Valley ER is a freestanding emergency care center committed to helping you understand and prepare for potential out-of-pocket costs related to medical services you or a loved one may receive at our facility. We have resources and staff available to assist you and answer your questions regarding these matters. We encourage you to contact one of our patient account service representatives at Concho Valley ER to discuss your specific financial needs and the potential associated charges. If you are insured, it may be necessary for you to contact your insurance carrier to understand your policy coverage for emergency room services.
A list of our charges is available to you for review.
The amount listed is not necessarily reflective of your actual financial responsibility. The amount collected by our facility can be less than the amount on this list for a number of reasons, including discounts negotiated with third party payers such as Multi-Plan, commercial insurance company negotiations as well as our other facility patient-specific discounts based upon financial need and other considerations. Again, we recommend that patients contact their insurer or our Patient Account Representatives at Concho Valley ER to discuss their individual financial situations, bills, or account balances.
This discussion with your insurer or the facility account representative is a vital step because several factors can affect an individual’s financial responsibility for the cost of facility care, including:
- If an individual has insurance, type of carrier, plan, benefit plan and coverage related to emergency benefits;
- Individual qualifications for additional financial assistance from the facility;
- Factors specific to each patient’s care and needs, such as:
- Length of stay in the facility – emergency room treatment or short-term observation
- Specific items needed for care
- Level of care and treatment required
- Additional testing required or recommended by your provider, and /or Unexpected complications.
Please contact the facility at any time with questions, or view our Frequently Asked Questions:
Freestanding emergency rooms and hospitals charge comparable pricing. However, you may find that a freestanding emergency room may be priced lower on some services than a hospital because we can obtain some services for less money and pass that savings onto our customers.
A: Unlike hospitals, our facility does not bill separately for any laboratory, pathology, radiological exams and related interpretations. You will receive two (2) bills:
- Emergency room physicians and a
- Facility bill. Your facility bill includes all diagnostic testing and interpretations (labs and radiology services).
The best way to determine your costs is to discuss your coverage options and needs with your insurance company or with one of our Patient Service Representatives. You will need to check with your insurance carrier to determine your emergency room coverage.
Since our facility is an emergency room, charges are determined by the amount of treatment and care needed for the patient which is determined by the doctor during the medical screening exam. Sometimes, life-saving interventions are required and time does not allow the doctor and staff to discuss costs of services. As required by law, the provider must first perform the medical screening exam to determine if a medical emergency exists before financial information can be discussed.
During the course of the medical screening exam, the provider may have to provide stabilizing and life-saving interventions and time will not allow for discussion of costs of services.
Charges and out-of-pocket costs vary from person to person, based on your specific insurance benefits, and are difficult for us to estimate.
A person’s financial responsibility – or out-of-pocket costs – is dependent on many factors, including if he or she is insured, by which insurer and under which plan he or she is covered, and if he or she qualifies for financial assistance. Because this varies so much from individual to individual, we cannot make blanket statements about actual charges or out-of-pocket costs.
Also, any charges that a patient incurs are dependent on a variety of factors such the seriousness of the patient’s condition (acuity), procedure/s performed, anesthesia administered, admission to short term observation, unexpected complications that arise, specific supplies and items needed for his or her care, and additional testing required or recommended to assess his or her condition. One patient’s needs may be vastly different from another’s even though they come to the facility for the same procedure. It is difficult to estimate how this can differ.
We do encourage all patients to contact their insurer or our Patient Service Representatives at Concho Valley ER to discuss their individual situations and further discuss billing and patient account balances.
More than likely, no. The amounts we have listed on our website are basic (often referred to as usual and customary) – undiscounted prices. They do not necessarily reflect a patient’s actual financial responsibility. These prices can vary significantly based on many factors, such as the care and services an individual requires, if he or she is insured, and by which insurer or plan he or she is covered.
The amount collected by our facility is almost always less than the amount provided on our website. Some insurances pay facilities much less than the amount listed and, since we don’t participate, many may pay according to your out of network benefit schedule. Our job is to appeal your claim and request that your emergency room visit be paid at the in-network rate in accordance with the law (prudent layperson). We will gladly work with your insurance carrier to negotiate a fair and reasonable claim settlement as well.
Our goal is to insure you have as little out-of-pocket expense as possible for your care! Regardless of what payments we may or may not receive from your insurance company, our guarantee to you is that we will bill you only those copays, co-insurance, and deductible amounts that you would have to pay if you were seen at any other hospital-based emergency room.
We also understand that market place and other plans have astronomical deductibles and catastrophic coverage so we are certainly willing to negotiate your charges and provide payment plan options as well.
Healthcare providers’ prices are based on the cost of the service (i.e. equipment and supplies, personnel, etc.), prices charged by competitors and prices of similar services offered.
Facility prices are set to take into account the expected mix of patients seen and reflect expected payments from varied insurance payors as their payments on claims are often inconsistent, vary from payor to payor, and dependent on the beneficiary’s policy and coverage. In addition, they are typically set to achieve an overall small positive margin, so a facility can keep up with community needs, reinvest in the facility’s services and facility, provide care for those who can’t pay, and collaborate with and support organizations that share its mission. We also review the local hospital fee schedules in our geographical areas and have often found we are cheaper on some or most services.
Prices vary because all facilities are different. Size, staffing, technology and equipment, services offered, the intensity of care provided, patients served, and many other factors all impact how much money a facility needs to operate – and how much it charges for services.
As you can imagine, we are subject to many legal and regulatory restrictions when it comes to patient costs, but we are offering programs, payment options and discounts that we can.
Patient Account Services at Concho Valley ER can help individuals determine the payment options and discounts may be available to them.
Because CMS will not recognize the licensed freestanding emergency medical care center as a provider. However, we certainly will see a Medicare, Medicaid, or Tricare patient but the patient would have to agree to pay cash for those services because we cannot and will not bill those insurances.
Reasons to choose the Freestanding Emergency Care Centers
Our prices are comparable to hospital emergency room pricing in our service area. We can see you faster than a facility ER and still provide the concierge care that you have been accustomed to receiving in private emergency rooms. We are more flexible when it comes to transferring to higher levels of care. YOU choose which facility you want to transfer for higher care and we will do all we can to accommodate your request.
We can turn our point of care diagnostic services around faster than hospitals because our patients don’t have to compete with the rest of the hospital departments for these services