As this legislative session approaches, a few coordinated efforts by the insurance companies have appeared seemingly out of the blue. Their sole purpose is to paint an unfavorable picture of Freestanding ERs. They are attempting to label FSERs as more expensive than the alternative by using their “out-of-network” status as a primary reason. However, the Texas Department of Insurance has claimed under Insurance Code Section 1301.155 that all individuals who seek emergency care must be reimbursed by their insurance company regardless of whether that facility is “in-network” or “out-of-network."
The reality is that insurance companies are chronically underpaying emergency hospital charges because they don’t believe a potentially life-saving procedure is what is considered “usual and customary.” It just so happens that by adopting this philosophy, that have also managed to save hundreds of thousands of dollars in unpaid claims.
When insurance companies are challenged, they have lost nearly 100% of the time.
Every month, you pay your hard-earned dollars on premiums from your insurance company. Now it's time for them to hold up their end of the bargain by honoring you and your health, and allowing you access to the best care that is available to you.