MYTHS VS. FACTS

 

FICTION: Freestanding ERs accept your insurance.

FACT: “Accepting all insurance” does not mean the freestanding ER is in your health plan’s network.

Freestanding ERs (FSERs) largely choose to remain out-of-network for most health insurance plans in Texas. FSERs use confusing advertising to intentionally mislead patients into believing they accept their insurance plans for full payment, but in reality, they choose not to be in network with most insurance plans in order to charge higher prices. This means insured patients will often get slapped with a bill that can be 10x what an urgent care center would charge for the same services – and it’s not covered by your insurance.

 

FICTION: Freestanding ERs are cheaper than urgent care centers or traditional hospital ERs.

FACT: Freestanding ERs charge up to 10X more than urgent care centers and are often more expensive than Texas hospital-based ERs

Charge like a traditional hospital ER but provide mostly routine clinic care: The top three reasons people visited freestanding ERs in Texas are fever, bronchitis and sore throat – conditions that could be treated for substantially lower prices at an urgent care or traditional doctor’s office. The average cost to treat bronchitis at a Texas freestanding ER is $2,944, compared to $136 at a traditional doctor’s office or $167 at an urgent care center.

Freestanding ERs bill you for more “extras:” Freestanding ERs in Texas have nearly 3x more costs associated with “extras” such as lab tests, x-rays and MRIs than traditional ERs, and 40x more than urgent care centers or physician office settings.

 

FICTION: Insured consumers are protected from surprise medical bills at freestanding ERs.

FACT: Surprise billing protections for patients do not apply to FSERs in Texas.

Texas has one of the highest rates of surprise medical billing in the nation. A surprise bill happens when a consumer receives out-of-network care unknowingly—often in an emergency situation. The risk of surprise billing is even greater at FSERs—nearly 70 percent of out-ofnetwork emergency claims for Texas ER facilities occur at freestanding ERs.