Insurance, Pricing and Billing Info
Insurance and cost of visit
Most emergency visits to the GYN Emergent Care Center are covered by insurance. To ensure that your emergency visit is completely covered by your insurance, we encourage you to become familiar with your insurance plan or to call your insurance directly to understand your benefits.
After you are done with the triage process and once our team knows what needs to be done, our patient coordinator will collect your insurance information. She will verify your benefits and, depending on your insurance, a payment in the form of your co-insurance, deductible, and/or a copay may apply. Usually, the ER copay amount is noted on the back of your insurance card. She will also let you know if any other charges apply to your visit. Co-pays are collected at time of visit.
The cash prices include professional and facility fees.
- A simple visit is considered any type of visit that does not require lab test or an ultrasound like Urinary Tract Infections or Vaginal Irritation.
- A visit that requires imaging and in-house labs
- A visit with imaging, in-house labs, IV medications and supplies and 1 hour observation time.
- In case your condition requires observation, medication and supplies for longer that one hour, an hourly charge of 75$ will be applied.
The Value Compared to Other Facilities
Compare the services at the GYN Emergent Care Center to other facilities offering OB/GYN services.
|REGULAR OB/GYN OFFICE||URGENT CARE||HOSPITAL ER||GYN EMERGENT CARE CENTER|
|Seen by OB/GYN Specialist immediately|
|Average cost of emergency visit is less than 50% of hospital ER|
|On – Site Lab, Imaging Center and Pharmacy||‘|
|On – Site Surgical Treatment||‘|
|Treatment – Stabilizes Condition||‘||‘||‘|
|Treatment – Solves Problem||‘|
|Plan of care and follow-up provided||‘|
|OB/GYN specialist available 24/7 over phone after emergency surgery|
As a part of the health care reform law, also known as the Patient Protection and Affordable Care Act (PPACA), there are several changes to how emergency room visits are covered.Insurers cannot require a prior authorization for emergency services, even if provided by an out-of-network provider.Insurers cannot charge higher co-payments or coinsurance for emergency services at an out-of-network provider.
Balance billing is not prohibited, but a “reasonable amount” must be paid before you are responsible for paying the balance of a bill.
Emergency services must be provided without regard to any other term or condition of the plan or health insurance coverage, other than:
- the exclusion or coordination of benefits;
- a permitted affiliation or waiting period; or
- sharing requirements that apply.
- Insurers may not put a requirement or limitation on benefits for out-of-network emergency services that are more restrictive than those that apply to in-network emergency services.
Note: The rules for emergency services do not apply to grandfathered plans. However, other federal and state laws related to these patient protections may apply regardless of grandfather status. These changes are effective for plan years beginning Sept. 23, 2010. For more information on health care reform, visit www.healthcare.gov.
Some health plans require certain services to be authorized, or pre-certified, before the patient receives them, however this should not apply to emergency visits like those mentioned above. The best thing you can do is to know your health plan’s requirements by reading the information given to you by your insurance provider or employer, or by calling your insurance provider directly.
If you call us prior to your visit and let us know why you are coming in, we can ESTIMATE the cost of your visit. We cannot guarantee any fees until after you have had your appointment. Payment is expected at the time of service. Please call 855-376-2496 for more information.
Yes, we offer an affordable cash fee schedule for self-paying patients and we offer special discounts for students.
Your insurance provider will send you an Explanation of Benefits (EOB) notice that details the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Complete Women Care for professional services or to the GYN Emergent Care Center for facility fees. Review your EOB carefully, compare it to your Complete Women Care and GYN Emergent Care Center billing statement, and call your insurance provider or a Complete Women Care billing representative right away if you have questions or concerns.
Just like a hospital, you will receive two separate bills from CWC. These will include:
- A professional physician service from Complete Women Care. For questions about the professional service fee please call the CWC Billing Department at 562 424 8422 ext. 6004.
- Facility service fees from the GYN Emergent Care Center . If you have questions about facility charges please call the EC Billing Department at 310 469 5111.
- For professional physician service fees from Complete Women Care, please call the CWC Billing Department at 562 424 8422 ext. 6004, Monday – Friday from 8:00am – 5:00pm.
- For facility service fees from the GYN Emergent Care Center please call the EC Billing Department at 310 469 5111, Monday – Friday from 8:30am – 5:00pm.
You can pay over the phone or online for the professional service fees from Complete Women Care. If you already have a Patient Portal account, please log in, click on billing, and you will be guided through the payment process. For facility service fees from the GYN Emergent Care Center you can pay by mailing a check or with your credit card by calling 310 469 5111, Monday – Friday from 8:30am – 5:00pm.