Open now — 24/7, holidays included
12000 N El Mirage Rd, El Mirage AZ
Billing (480) 339-4825
Your rights
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
Protected by federal law
Your share is limited to in-network cost sharing.
An EOB is not a bill
It is a statement of what your insurer paid.
Ask us before you pay
Call if anything you receive is unclear.
What “balance billing” (sometimes called “surprise billing”) means
When you see a provider or visit a health care facility, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that is not in your health plan's network.
“Out-of-network” describes a provider or facility that has not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan's deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care — such as in an emergency, or when you schedule a visit at an in-network facility but are treated by an out-of-network provider.
You are protected for emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they may bill you is your plan's in-network cost-sharing amount — such as copayments, coinsurance and deductibles. You cannot be balance billed for these emergency services.
This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balance billed for those post-stabilization services.
Federal law also:
Bans surprise bills for most emergency services, even when you get them out-of-network and without approval beforehand (prior authorization).
Bans out-of-network cost-sharing — such as out-of-network coinsurance or copayments — for most emergency services. You cannot be charged more than in-network cost-sharing for these services.
Bans out-of-network charges and balance bills for certain additional services, such as anesthesiology or radiology, provided by out-of-network providers as part of a visit to an in-network facility.
What we do beyond the law
We never balance bill
Not for any patient. Broader than the federal protection, because it has no exceptions.
An EOB is not a bill
It states what your insurer paid. Read it to us before you pay anything.
Ask us first, always
Billing will walk you through any statement. It costs nothing and takes one call.
Care is never conditioned on payment
You are screened and stabilised whatever you can pay.
We are out of network with all insurance plans, and we say so plainly — including on Billing & Insurance, where the whole arrangement is set out.
We do not balance bill. Ever. Not for any patient, whatever insurance you have and whether or not you have any. That is our own policy and it is broader than the federal protection, which applies to emergency services and to particular situations rather than to everything.
If something arrives from your insurance company after your visit, it is almost certainly not a bill. An Explanation of Benefits is a statement of what your insurer paid. Call our billing team on (480) 339-4825 and read it to us — that is the fastest way to settle it, and it costs nothing.
And if an out-of-pocket amount is the problem, HealthPass pays members' out-of-pocket costs for visits here, including visits already behind them. It is a separate company and it is not insurance.
If you are uninsured or paying for yourself
In most cases you can get a good faith estimate of how much your care will cost before you receive it.
If you are charged substantially more than your good faith estimate, you can dispute the bill. CMS publishes the thresholds for this — for services provided in 2022, a dispute could be raised where final charges were at least $400 higher than the good faith estimate, filed within 120 days of the date on the bill. Check the current figures at CMS.gov/nosurprises before relying on them, and call our billing team, who will go through it with you.
Some coverage already carried these protections. If you have coverage through Medicare, Medicaid or TRICARE, or you receive care through the Indian Health Service or the Veterans Health Administration, you were already protected against surprise medical bills from providers and facilities that participate in those programs.
If you believe you have been billed incorrectly
Contact us first — most of these are resolved in one phone call. Billing: (480) 339-4825.
Federal: visit CMS.gov/nosurprises or call the No Surprises Help Desk on 1-800-985-3059. TTY users can call the same number.
Arizona: the Arizona Department of Insurance and Financial Institutions handles health-insurance complaints and the appeals process — DIFI — health insurance and the appeals process · DIFI — file a complaint.
How this works in Arizona
The federal protections above apply in Arizona in full. The Centers for Medicare & Medicaid Services (CMS) confirmed in its enforcement letter to Arizona (February 23, 2022) that CMS itself “will directly enforce” the No Surprises Act's balance-billing rules in Arizona “with respect to … health care providers (other than allopathic and osteopathic physicians), facilities, and providers of air ambulance services.” For a facility like this one, the enforcer of the federal law in Arizona is CMS.
Physicians answer to Arizona's own boards for these rules. Per the same letter, the Arizona Medical Board enforces the No Surprises Act's balance-billing provisions for Arizona-licensed physicians, and the Arizona Board of Osteopathic Examiners does so for osteopathic physicians.
Arizona also has its own surprise-billing law — the Surprise Out-of-Network Balance Billing Dispute Resolution process, A.R.S. §§ 20-3111 through 20-3119, run through the Arizona Department of Insurance and Financial Institutions (DIFI). It lets an insured patient who receives a surprise out-of-network bill start a dispute over the amount. It sits alongside the federal law rather than replacing it: CMS's letter notes that because the Arizona process is one the patient must initiate, the federal independent dispute resolution process applies in Arizona for deciding what insurers pay out-of-network providers — so the payment fight happens between the insurer and the provider, not on your shoulders.
If you are uninsured or paying for yourself, the federal patient-provider dispute process applies in Arizona (the state has no equivalent of its own, per the CMS letter): if a bill comes in substantially above your good faith estimate, you have 120 days from the first bill to dispute it — the details and the current dollar threshold are at CMS's medical bill rights site.
Where to raise a problem, by who caused it
None of this changes the promise at the top of this page. This facility does not balance bill any patient for any reason — a commitment broader than either the federal or the Arizona law, because it has no exceptions to enforce.
El Mirage ER — open 24 hours a day, 7 days a week.
12000 N El Mirage Rd, El Mirage, AZ 85335 · Billing: (480) 339-4825 · Main: (480) 237-4922
If this is a medical emergency, call 911.
About your bill, before you worry about it
If something arrives from your insurance company after your visit, it is almost certainly not a bill. It is an Explanation of Benefits — a statement of what they paid. The large number on it is not what you owe.
For emergency care, federal law limits your share to the ordinary in-network copay, coinsurance and deductible your plan already sets. We do not bill you for the difference, and we never will.
If anything you receive is unclear, call us before you pay it. Our billing team would rather explain a statement than have you pay something you do not owe.