Lonestar 24 HR ER accepts all commercial and private insurance.
In the State of Texas, all emergency visits are required to be reimbursed by your insurance carrier regardless of whether that provider is “out-of-network” or “in-network.” Unfortunately, federal regulations and the Centers for Medicare and Medicaid Services do not allow us to participate with or accept Medicare, Medicaid, or Tricare but we do offer cash options instead.
Lonestar 24 HR ER offers payment plans and substantial discounts for cash payments.
Texas Health Care Statutes
The Texas Department of Insurance Code, Section 1301.155 on Emergency Care requires that insurance companies pay emergency facilities “at the insured’s in-network benefit level” for all services. Additionally, the Patient Protection and Affordable Care Act added numerous patient protections that require health plans covering emergency services to provide such coverage without need for prior authorization, regardless of the participating status of the provider, at the in-network level.
Furthermore, health plans are required to pay for emergency visits for medical situations in which a person believes his or her health is threatened. The final diagnosis should not influence whether the insurer pays for the emergency room visit, and insurers cannot legally apply the claim towards the out-of-network benefits.Click here to view a helpful guide on the differences between free standing emergency care facilities, such as Lonestar, and other medical facilities.
Freestanding Emergency Care
Lonestar 24 HR ER is a freestanding emergency medical care facility. Lonestar 24 HR ER charges rates comparable to a hospital emergency room and may charge a facility fee. Facility and physicians providing medical care at the facility are not a participating provider in the patient’s health benefit plan provider network. Lonestar 24 HR ER physicians providing medical care at the facility may bill separately from the facility for the medical care provided to a patient.
Pursuant to Senate Bill 425 and House Bill 3276, the following is for your information:
- This facility is a freestanding emergency medical care facility;
- This facility charges rates comparable to a hospital emergency room and may charge a facility fee;
- This facility or a physician providing medical care at the facility may not be a participating provider in your health benefit plan provider network; and
- The physician providing medical care at this facility may bill separately from the facility for the medical care provided to you.
- This facility is not a participating provider in any health benefit plan provider network. However, under the Affordable Healthcare Act (ACA/Obamacare), your health insurance company is required to process your emergency visit at in-network benefit levels.