Understanding Your Bill

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Understanding your bill

When you go to Fair Oaks Emergency Room, it is important to understand how the billing process works to avoid confusion and unexpected costs. Here is a breakdown of what typically happens with your bill:

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Health Insurance Claim Filing

After receiving medical services at a Fair Oaks Emergency Room, a health insurance claim is filed with your insurance company. This claim details the services provided and the associated costs.

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Patient Responsibility

Depending on your insurance plan, you may have a copay (a fixed amount) or co-insurance (a percentage) that you are responsible for paying at the time of your visit. Your insurance company will cover the remaining portion of the bill based on your coverage.

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Explanation of Benefits (EOB)

Following your visit, you will receive an Explanation of Benefits (EOB) from your insurance company. The EOB outlines the services received and their costs but is not a bill itself. THIS IS NOT A BILL FROM Fair Oaks Emergency Room. Our billing team will send a statement once your bill is finalized and discounts are applied if applicable.

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Separate Billing

You will receive a facility and physician bill from different entities involved in your care at the Fair Oaks Emergency Room.

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Insurance Coverage

It’s essential to be aware of whether the Fair Oaks Emergency Room is out-of-network with your insurance plan to understand potential costs and coverage limitations.

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No Surprises Act

In line with patient protection measures, the Federal No Surprises Act (NSA) was enacted by the federal government. The NSA aims to prevent surprise billing, which occurs when patients receive unexpected bills for services rendered by out-of network healthcare providers or facilities. Under this act, out of-network providers are prohibited from billing patients beyond their yearly in-network deductible and co-insurance.

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Reviewing Bills

When you receive bills related to your visit, carefully review them for accuracy and contact the billing department at (979) 500-3008 if you have any questions or concerns.

Understanding these aspects of billing can help patients navigate their healthcare expenses more effectively and prevent surprises down the line.