Under federal law, Priority Emergency Center is required to provide you with a clear disclosure of your rights and protections against unexpected medical bills — commonly known as "surprise billing." This page explains those rights in full.
You cannot be balance billed for emergency services received from out-of-network providers.
Your health plan must cover emergency services without prior authorization, even from out-of-network providers.
If you believe you have been wrongly billed, you have the right to contact the Federal No Surprises Helpdesk.
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs such as a copayment, coinsurance, and/or a deductible. These are normal and expected costs.
"Out-of-network" describes providers and facilities that haven't signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan considers "allowed" and the full amount charged for the services. This is called "balance billing." This amount may be more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
"Surprise billing" is an unexpected balance bill. This may happen if you cannot control who is involved in your care — like when you have an emergency, or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
If you have an emergency medical condition and receive emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan's in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for emergency services.
This includes services you may receive after you're in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.
When you receive services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan's in-network cost-sharing amount. This applies to:
These providers cannot balance bill you or ask you to give up your protections not to be balance billed. If you receive other services at these in-network facilities, out-of-network providers can't balance bill you unless you give written consent and waive your protections.
Important: You're never required to give up your protections from balance billing. You also aren't required to get care out-of-network. You can always choose a provider or facility in your plan's network.
When balance billing isn't allowed, you also have the following protections. You are only responsible for paying your share of the costs (copayments, coinsurance, and deductibles) that you would pay if the provider or facility was in-network. Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
If you believe you have been billed incorrectly or your rights under the No Surprises Act have been violated, you have two options:
You may also contact the federal helpdesk directly if you believe your rights have been violated:
Questions about your bill or this notice?
Contact Priority Emergency Center at (737) 423-2311 or info@pec247.com
3563 Far W Blvd Suite 110, Austin, TX 78731 · Open 24 / 7, 365 Days a Year