Freestanding ER Bills Still Confusing To Some, Despite Law Aimed To Make Charges Clearer

Freestanding ER’s are a relatively new business across North Texas.

They are private businesses which provide convenient service. But some patients tell us, the convenience has brought confusion.

They are receiving large bills after treatment, as insurance companies and the Freestanding ER operators haggle over what treatment is covered.

Lou Marchant first called us back in 2016.

A new Emergency Room and Urgent Care center opened in her Keller neighborhood.

She tried them out when she had a pain in her side and a few weeks later received a bill for more than 14-hundred dollars after insurance.

The bill was $4,325 and I still owed $1,420," she said. "I called Channel 5 News because I saw how successful you were with getting these kinds of things resolved.

NBC 5 Responds got the issue resolved for her back then.

The company said the bill was just an estimate and told us Lou was right it was confusing so they took care of it and left her with a zero balance.

Complaints like hers were not unique. Stories like Lou’s were hitting the desks of Texas lawmakers, stories of people getting hit with huge bills from freestanding emergency rooms.

The house passed a bill requiring freestanding ER facilities to tell you upfront whether they're in network and how they bill upfront.

Our partners at the Dallas Morning News examined dozens of documents from different freestanding ER's.

They found that there we inconsistencies between the different ER’s. In some cases it wasn’t clear whether the ER’s were in insurance networks or not.

State Representative Tom Oliverson of Cypress introduced the bill. 

It dictated the businesses had to point out their services would be billed much like a hospital.

It also required them to disclose if they charge a facility fee, and whether the visit was in-network or not.

He looked at the same documents our partners at the Dallas Morning News did. He saw some improvement since the bill became law but not enough.

We called Lou back in for her take on if the law made things better.

"When I read this, they're really not telling you what things are going to cost," said Marchant.

The Texas Health and Human Services Commission licenses the stand-alone ER's. They have inspected 15 freestanding facilities since the new law took effect, and none were cited for not meeting the requirements of the new law.

They told us "we generally try to work with facilities to get them into compliance," "We welcome consumer complaints and if any facility is not compliant with the law, we would want to know about it."

Lou says while lawmakers were trying to help, it's clear more work needs to be done to help consumers avoid unexpected medical debt.

"It used to be your big bills were your house and your car, not it's your big bills are your medical bills," said Marchant.

The Texas Association of Freestanding Emergency Rooms told us the law protects patients and said "If processed properly by the health insurance company the patient responsibility shouldn't be different whether that facility is in network or out."

Representative Oliverson is planning to push for stricter enforcement of the law to make sure it’s being followed and patient’s rights are being protected.

You can read more about what's next for freestanding ER's from our media partners at The Dallas Morning News by clicking here.

Contact Us