Billing & Insurance

Concho Valley ER participates in private insurance plans such as Aetna, Humana, United Health, Cigna, and BlueCross/BlueShield. We also accept out-of-pocket payment in the form of cash, checks or credit cards.
*Come in for a complimentary basic medical screening to get a cost estimate.
Senate Bill 425

• Concho Valley ER is an emergency room.

• Concho Valley ER charges rates comparable to a hospital emergency department, including a possible facility fee.

• The physician may bill separately from the facility.

• Concho Valley ER and facility-based physicians may not be a participating provider in an individual’s health plan network.

For more information about Senate Bill 425, click here.

In-Network vs. Out of Network

According to guidelines set by the state of Texas, all insurance carriers must pay in-network benefits for any member who is seeking emergency medical treatment. 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.

Texas State law mandates that patients are reimbursed for ER visits by their insurance carrier. If your insurance provider is refusing to reimburse you for your emergency room trip, you can file a complaint with the Texas Department of Insurance (TDI). For more information about this process and the Texas Department of Insurance visit http://www.tdi.state.tx.us.

Understanding your Bill

At Concho Valley ER, we strive to be fair and transparent with our billing and realize that some patients may find the billing process confusing or overwhelming. We want to help you understand your bill. Your bill may be different from other medical bills you may have received from hospitals or physicians. It’s important to note that Concho Valley ER is a freestanding emergency center.

This means that we function like a hospital-based emergency room. According to Texas state guidelines as discussed above, all insurance carriers must pay in-network benefits for any member who needs emergency medical treatment. The law states that you are to be reimbursed by your insurance carrier for emergency room visits. Texas law requires insurance carriers to pay for emergency care.

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. However, depending on the insurance plan you have the treatment you received, there could be additional charges associated with your ER visit.

Concho Valley ER is classified as out of network with many insurance companies; however, Concho Valley ER does honor all in-network deductibles and benefits, and we will contact your insurance provider to let them know that we are honoring in-network benefits.

Concho Valley ER Billing Policy

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 first one for the facility and the second one for the physician. Radiology, pathology, or cardiology over-reads are not charged separately, as is the case with hospital-based ERs. The charges are instead included in the facility bill. The facility fee is calculated on a point system based on the procedures performed, potential liability, patient acuity, and the complexity of the physician/patient interaction.

If you have any questions concerning your bill please contact our Billing Department, Tyvan Billing at 713-357-2535. We will work with you quickly to resolve any issues.