FAQs

Yes, all TotalCare ERs and clinics offer extensive treatment options for adults and children alike. TotalCare Behavioral Health sees patients 6 and older.

For all questions regarding a bill from a TotalCare clinic or urgent care (including TotalCare Behavioral Health), please email billing@totalcare.us.
If you are a patient of TotalCare Emergency Room with a question about your bill or service, please contact our Patient Experience team at experience@totalcare.us or by calling (817) 989-9441.
If you are a representative of an insurance company with a question about a bill from TotalCare Emergency Room, please email ERbilling@totalcare.us.

All four of our TotalCare primary care clinics also operate as urgent care facilities after traditional hours. Urgent cares are typically open later than a normal doctor’s office — until 8 pm on weekdays and open during the day on most Saturdays and Sundays — but are not open 24-hours like our ten Total Care Emergency Rooms.

There is also a difference in the level of services and care that each facility can provide. An urgent care is able to diagnose and treat conditions that are severe but not life-threatening, like small lacerations, flu, strep throat, or strong pains. They might have an X-ray machine and some labs but will not have a CT machine. An emergency room, on the other hand, is equipped and staffed for conditions that could be considered life-threatening and need immediate medical attention. This includes chest pain, abdominal pain, dehydration, bone fractures, and severe illness. There is also imaging and extensive labs onsite, including CT, sono, and X-ray — and even a radiology tech onsite 24/7.

TotalCare Emergency Rooms are each licensed by the State of Texas as a Freestanding Emergency Medical Care Facility and are required to be open 24/7/365, with experienced emergency medicine physicians and registered nurses onsite at all times. These facilities are also required to have the same diagnostic equipment as a traditional ER attached to a hospital, like X-ray, CT, and sonogram.

That means that TotalCare ERs can provide any major or minor emergency service, but without the waiting room of a large hospital. TotalCare ER is also independently owned, so we can send results or charts or patient records to any medical provider without concern for hospital network or affiliation.

When a facility or doctor is “in-network” with an insurance plan, it means that the payer (insurance) and the provider has a contract in place to lay out what rates will be charged for any services that are given.”Out-of-network” means that the provider does not have a pre-existing contract with the insurance company to agree on the rates or fees.

State law requires that all patients in licensed emergency rooms (freestanding or hospital-based) must be treated as if they are in-network, even if the facility is officially “out-of-network” according to the insurance company.

Because we are licensed as a freestanding emergency room, TotalCare-ER are unable to contract with insurance companies. However, while we are considered an out-of-network facility, all insurance carriers are required by State and Federal law to pay in-network benefits for any member patient who requires emergency medical treatment. The state of Texas empowers patients to use a prudent layperson standard when considering what constitutes an emergency.

Therefore, all health insurance companies are legally required to process emergency ER visits at TotalCare at an in-network benefit level and TotalCare will attempt to file with most private insurance plans.

Freestanding Emergency Medical Care Facilities such as TotalCare Emergency Room cannot participate in federal government programs such as Medicare, Medicaid or Tricare because the federal government does not recognize emergency room facilities that operate independent of a traditional hospital system. The federal government enforces this rule; this is not a choice made by the executive leadership of TotalCare Emergency Room.

However, we will never refuse treatment in any life-threatening situation, regardless of the ability to pay.

No, insured patients will not receive a bill from TotalCare for any amount that was not disclosed at the time of service.

For patients with most standard commercial insurance, your estimated out-of-pocket cost will be collected at the time of your visit. Then, TotalCare will send two separate claims to your insurance company — a facility charge and a physician charge. (Note: We will not send any separate bills for imaging, labs, cardiology, radiology, or anything else, as is often the case from a traditional hospital ER.)

A few months after your office visit, you will likely receive an Explanation of Benefits (EOB) from your insurance company. Feel free to review the EOB to fully understand your benefits and the charges and payments that have been worked out between the insurance company and TotalCare. But, your EOB is NOT a bill and you will not receive a bill from TotalCare for any amount that has not been paid by the insurance company and was not disclosed at the time of service.

If you have questions about your costs, please contact our Patient Experience team at experience@totalcare.us or by calling (817) 989-9441.