Non-network Emergency Room Services
Posted 06/21/2017
Payments by HealthChoice for non-network services provided in the emergency room setting are identical to those provided for a network setting. If a member is admitted to the hospital through the emergency room, network benefits are applied to the emergency room charges, the services rendered in the emergency room, and all covered inpatient and related ancillary services for the same admission. Non-network providers are permitted to balance bill for the difference between the allowed charges and billed charges. The plan is not responsible for any payments related to balance billing.