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 emergency center.

Click the links below to learn more:

1Victoria's ER Billing Policy

Victoria ER accepts 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.

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 361-403-0517.

2Insurance 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 classified as out-of-network with many insurance companies; however, Victoria ER does honor all in-network deductibles and benefits.

3What 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.

4Are We In-Network?

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

5Why are Senate Bill 425 and House Bill 3276 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 not be a participating provider in 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 not a participating provider in any health benefit plan provider network. However, by state law your health insurance company is required to process your ER visit at in-network benefit levels.

6EOB

• Within the next month, you will receive an EOB (Explanation of Benefits) for the Physician Visit and Facility Visit.

• Do not be frightened, it will say "NOT A BILL".

You do not have to do or pay anything when you get the EOB.

• After your visit, you will receive 2 bills:

• Facility Bill and a Physician Bill

• Once your insurance company has finalized your claims, you will receive a statement from these entities: Victoria ER (Facility Bill) and Victoria EP (Physician Bill).

Thank you again for choosing Victoria ER. For any questions regarding your medical bill, please call F & A Billing at (361) 403-0517 to speak to a Patient Advocate or utilize the online bill payment portal on our website.