Our Billing Process

At the time of your visit, your emergency room co-pay will be collected. After your visit, two separate claims will be mailed to your insurance company; one for the facility and one for the physician. Your insurance company will NOT be charged separately for radiology, pathology, or cardiology reports, as is the case with hospital-based ERs. Instead, these charges are included in your facility bill. Please note: Exceptional Emergency Center locations are not in-network with any insurance benefit plans, however, your health insurance company is required by law to process emergency ER visits at an in-network benefit level. Exceptional Emergency Center in Orange, Beaumont and Port Arthur, and Amarillo Exceptional Community Hospital do accept Medicare.

Ask us for information on our Prompt Pay Discount. We accept cash, checks, and all major credit cards; including Visa, MasterCard, AMEX and Discover Card.

NOTE: Emergency rooms must maintain an extremely high level of preparedness to effectively treat emergency medical conditions and ensure you have access to the best in emergency care. Therefore, emergency rooms charge a facility fee for each patient visit to help offset the recurring costs associated with maintaining this level of preparedness that is much higher than traditional medical facilities. The facility fee is a charge that is calculated on several different factors and criteria by patient. Acuity level is determined based on; review of patient symptoms, history, physical information, severity of presenting issue, and necessary medical decisions made by the physician for any underlying issues (based on the information given as well as results of procedures and testing performed). These are graded as minimal, moderate and high severity.

About a month after your office visit, you will receive an Explanation of Benefits (EOB) from your insurance provider. You can review the EOB to fully understand your benefits; it explains what care you have received, what your insurance plan has paid and what your anticipated responsibility is (what you can expect to be billed). Your EOB is NOT a bill.

After applying your insurance provider’s benefit, if there is a remaining balance, NEC will send you a bill. This normally arrives 2-4 weeks after you receive the EOB. As a result of possible in-network adjustments, this bill might be less than what your EOB had shown.

If you have any questions regarding your bill, please contact Billing Services at 1-800-417-0740. We will work with you quickly to resolve any differences.

We look forward to serving you in the future.

Download our Model Disclosure Notice or read about Balance Billing.

Frequently Asked Questions

I’m confused about some the different terms used for payment. How do insurance benefits work for an Emergency Room (ER) visit?

  • Co-pay: The amount due at time of service. This amount is set by your insurance provider and varies depending on where you seek treatment.
  • Deductible: The amount set by your insurance company as the minimal amount you are personally responsible for before insurance will begin to contribute towards medical bills. Plans can have a deductible for an entire service, or labs, testing and procedures. A deductible may be due in conjunction with your co-pay.
  • Co-Insurance: Percentage of your medical bill you pay after your deductible is met. This may be due in conjunction with your co-pay and deductible.

What is an E.O.B?

An explanation of benefits (EOB) statement usually arrives via mail from your insurance provider and is often confused as a medical bill. The EOB is not a bill. The EOB notifies the patient that a medical insurance claim has been processed and explains what PRELIMINARY portion was paid to the health care provider, and what portion of the payment, if any, is the patient’s responsibility.

I just received my EOB and the “out of pocket cost” is concerning me.

Please understand the EOB is a starting point and NOT a bill. There are usually subsequent adjustments on the account to allow for in network benefits. Please wait for the Exceptional Emergency Center’s bill to understand any financial obligations. The bill will reflect any adjustments resulting from your insurance coverage.

I need an itemized bill; can you provide this?

We’re happy to help. For immediate service, please reach out to our billing team at 1-800-417-0740. Office hours are 8AM to 5PM, Monday through Friday.

I have questions about my bill. Who should I contact?

You’re not alone, medical bills are notoriously confusing and Exceptional Emergency Center has setup a process to help ensure you receive clear and quick answers to any questions you might have. If you need additional information about your bill, contact our billing team at 1-800-417-0740.

My insurance company is claiming your location is “out of network”. Can you help?

State and Federal law requires that emergency visits at the emergency room are covered by the insurance carrier, whether the emergency room is in-network or out-of-network. If your insurance company refuses payment for your emergency room visit, you can file a grievance with the Texas Department of Insurance.

To learn more about the Texas Department of Insurance, please visit tdi.state.tx.us.

Why haven’t I received a statement?

It usually takes 30-45 days for your insurance plan to process your claim. You will receive your EOB after processing and we will receive payment 2 weeks after that. If we are appealing a low consideration by your insurance for you, the process could take up to 60 days longer.

What does an “adjustment” mean?

An adjustment refers to the reduction made to your account to take into consideration the in-network allowable rate. We honor the insurance designated allowable rate.

What if I don’t have insurance?

We will work with you and are happy to create a payment plan.