What you can expect
After your visit to the emergency room, multiple claims will be filed to your insurance carrier. CapRock Health will send one claim for the facility, the physicians, and if you receive any radiology services such as a CT, x-ray and/or ultrasound, a claim will be sent by Synergy Radiology for the interpretation.
Why am I receiving a bill when I already paid my co-pay?
At the time of service, your ER co-pay was collected. We then filed with your insurance for your ER benefits. The balance due represents your deductible, coinsurance, and other non-covered services.
What is a deductible?
A deductible is the amount you must pay out-of-pocket for expenses before your insurance company will begin to cover your medical bills. Typically, the deductible starts over at the beginning of the calendar year and each family member must meet their own deductible.
What if my insurance says you are out-of-network?
Our facility is not a participating provider in any health benefit plan provider network, however, network status DOES NOT MATTER for emergency care (per Texas Insurance Code – Section 1301.155 – Emergency Care and SEC. 2719A [42 U.S.C. 300gg–19a]. PATIENT PROTECTIONS). Texas Insurance LAW guarantees that all fully-funded medical insurance plans must pay for ALL emergency medical claims at the in-network level regardless of network status. This means that your visit will be processed under your in-network benefits. If your insurance company does not process it correctly the first time, our billing company will work on your behalf to correct the insurance company’s error, and get your claim processed in-network under your emergency room benefits. Quite simply it is a violation of law for your insurance company to refuse to pay in-network for an emergency visit to a licensed ER such as CapRock ER. If you need assistance, please don’t hesitate to contact our billing company, they are here to help!
Price transparency
Building a patient-centered experience is not limited to our medical care, but also directs our customer billing and financial policies. Keeping patients first, CapRock is pleased to provide access to our pricing for hospital and ER services (Please know that these prices are for estimation purposes only. Urgent Care prices not included). Price List
Please understand, a patient’s insurance carrier and plan specifics are what actually determine the cost of a given service. The prices listed only represent the amounts that CapRock Health will request for payment from your insurance carrier. But your insurance carrier then determines what part of the request they will approve for payment. As CapRock Health does not “balance bill,” you will never receive a bill from CapRock seeking the difference for the amount requested over the amount approved by your insurance carrier. Any bill you receive will represent the “patient responsibility” that CapRock is required by your insurance company to collect. To clarify, the prices listed represent CapRock’s request to your insurance carrier. Your insurance carrier will then determine what you owe, and CapRock will only send a bill for that amount.
As it is difficult to determine your out of pocket expenses ahead of time, we encourage patients to contact our Billing and Financial Services department to discuss your unique insurance policy and coverage questions.
To speak with a CapRock Health representative directly, please call 979.314.2323 – Option 4.
Know your benefits
Health insurance benefits may seem complicated, but there are a few basic points all of us should be familiar with. Find out if you have co-pays, deductibles, coinsurance or anything else that may be your responsibility. These amounts are what actually determine your out-of-pocket costs.