ER Frequently Asked Questions

The Emergency Room will bill all insurance programs including Aetna, Humana, United Health, Cigna, and BlueCross/BlueShield. We also accept out-of-pocket payment in the form of cash, checks or credit cards for Uninsured patients. Your ER co-pay will be collected at the time of your visit. We will then bill your insurance company for the policy’s emergency room and observation benefits. There will be two different claims mailed to your insurance company: the facility bill and the physician bill.

• Fountain Hills Emergency Room (emergency and observation) Will NEVER BALANCE BILL PATIENTS even when OUT OF NETWORK.
• Fountain Hills Emergency Room HONORs ALL in-network benefits for emergency services and observation services.

After your visit – you will receive an Estimation of Benefits (“EOB”) from your insurance company. This is not a bill. You might also receive aggressive language from your insurance company about your care being out of network. However, remember that your insurance company is mandated by law to pay a fair rate to us for your ER visit. Our ER is out of network for all insurance, but we bill all insurances and will accept fair payments from your insurance company. We are committed to working with our patients who may have high deductibles.

We DO NOT balance bill our patients ever. If you do get a bill from us for your ER visit and have questions regarding patient responsibility,  please call our billing department for further clarification. You might not have any additional out-of-pocket responsibility after your insurance covers their part. Our patients already pay thousands in insurance premiums, and this is taken into account as well

An Explanation of Benefits (EOB), or an email from your insurance carrier is NOT A BILL. If you are not sure about what you have received, please call the insurance company initially to address the clarification and then Medical Center for any further clarification.

We do not balance bill patients for any services we provide. This is applicable to all patients regardless of which company they are insured with.

Yes, the Fountain Hills Emergency Room accepts uninsured/self-pay patients. Our first priority and commitment is the health and medical care of our patients. When patients arrive at the ER, they will be assessed and an emergency medical screening will be performed. Pricing will be available based on each patient’s condition.

If you require financial assistance, need help understanding your bill or would like to make payment arrangements, please contact our billing department.

We are currently credentialing our providers in the Medical Center with the major insurance carriers. Regardless of how long the process takes, we will always honor in-network deductibles and coinsurance in our facility from day one of opening.

In addition – Arizona carriers are required to pay in-network benefits for any member seeking emergency medical treatment. Arizona law requires your insurance carrier to pay for your emergency care, whether the emergency room is “in network” or “out of network”. The state of Arizona gives you the right to use “a prudent layperson standard” in considering what constitutes an emergency.

FHMC honors all in-network deductibles and coinsurance. In other words, you will never pay more than your in-network deductibles and coinsurance in our facility, regardless of your insurance. Our goal is to reduce or eliminate financial barriers to seeking medical care.

In emergency situations, Fountain Hills Emergency Room works with patients to establish a reasonable accommodation or payment plan for all monies owed due to the patient’s responsibility.

Commercial insurance companies are required by the State and Federal Law to pay for the emergency evaluation of a patient presenting to an Emergency Department in the State of Arizona. It is your right to file a grievance with Arizona Department of Insurance at https://insurance.az.gov/ if your insurance company refuses to pay for an Emergency or Medical Center visit.

We accept Medicare/Medicaid/Veterans/Indian Health patients both in our Emergency Room and Medical Clinics. FHMC however is a Physician owned medical center and we do recognize the challenges involved in seeking full CMS approval and are determined to overcome them in a short period of time. These challenges will not prevent us from taking care of patients at our facility regardless of what insurance they have. Patient access to care is the priority at our facility and we will overcome any challenges involved in getting CMS approval.

You have a responsibility to forward such a check to Fountain Hills Medical Center or billing company upon receipt.

Absolutely. It is mandatory under Arizona law to secure Workers Compensation. Regardless of who is at fault, workers injured at work are entitled to Health care benefits. Compensation must however be filed by the injured worker within one year after injury occurred. Please visit the Industrial Commission of Arizona Claims Division for more information.