Billing & Insurance

Thank you for choosing Victoria ER for your emergency medical care. We understand that some patients may find the billing process confusing or overwhelming. To better serve you, we want to make the billing process simple and transparent. Your bill may be different from other medical bills you may have received from hospitals or physicians. It’s important to note that Victoria ER is a freestanding 24 Hour Emergency Victoria center.

Click the links below to learn more:

1. Victoria ER's Billing Policy

To learn more about the coverage of your insurance at Victoria ER, call us at 361-214-3813. We also accept out-of-pocket payment in the form of cash, checks or credit cards.

To view a list of our current charges, click here

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 facility bill and the physician bill.

If you have any questions concerning your bill please contact our Billing Department, F&A Billing at 361-484-5131
2. 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.

Victoria ER is an out of network facility. Out of network simply means that the doctor or facility providing your care does not have a contract with your health insurance company. Conversely, in-network means that your provider has negotiated a contracted rate with your health insurance company.
3. What is Worker's Compensation?

Workers’ compensation is a state-funded insurance program that gives covered employees income and medical benefits if they’re injured while working. Texas employers may choose to provide their employees with this coverage. Most employers will inform you as to whether or not you’re covered under this state plan.

Workers’ compensation pays medical bills and is covered underneath the Texas Workers’ Compensation Act.

For more information on workers’ compensation, visit this page.

If you’d like to file or dispute a claim, call 800-252-7031, option 1, to speak with a representative with the Texas Department of Insurance.
4. The Prudent Layperson Standard

For all cases deemed emergent, 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.

If your insurance provider is refusing to reimburse you for your emergency room visit, 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
5. Why are Senate Bill 425 and House Bill 2041 so important to me?
According to guidelines set by the state of Texas, all freestanding ERs are required to post the notice below at their facility and website:
- The facility is a freestanding emergency medical care facility;
- The facility charges rates comparable to a hospital emergency room, and may charge a facility fee;
- A facility or a physician providing medical care at the facility may be an out-of-network provider for the patient’s health benefit plan provider network”
- A physician providing medical care at the facility may bill separately from the facility for the medical care provided to a patient; and.
- This facility is an out-of-network provider for all health benefit plans.