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Insurance Information

Open 24/7, No Lines.

Open 24/7 every day of the year, including Holidays.

Altus Lumberton Hospital uses state-of-the-art equipment and proven methodologies designed to yield fast and accurate diagnosis and treatment of acute and chronic symptoms as well as trauma-induced injuries.

Our team of in-house board-certified doctors, nurses, technicians, and administrative staff are always available to offer our patients the best medical care in the area. Here we treat everyone like family.

Altus Lumberton Hospital Insurance Information

Altus Lumberton Hospital welcomes all major insurance companies.

Tricare

Altus Lumberton Hospital is proud to be a TRICARE provider. We value our brave men and women in uniform and are grateful for the opportunity to give back and provide the best healthcare to the members of the military and their families.

We accept all TRICARE plans, including:

  • TRICARE Prime
  • TRICARE Select
  • TRICARE For Life
  • TRICARE Reserve Select
  • TRICARE Retired Select
  • TRICARE Young Adult

Private Insurance Plans

We welcome healthcare plans from all major insurers, including but not limited to:

  • Cigna AETNA
  • BCBS
  • Humana
  • United Health Care

 

Although we are not currently affiliated nor participate with any in-network payor, under the protection of the Federal and State laws, you are guaranteed coverage in an actual emergency. As soon as you enter our facility, our specialists will be ready to assist you. They will start the process by validating your insurance benefits; later, they will process claims on your behalf.

Our Mission is to Ensure Our Patients Wellbeing

We have worked hard to ensure our patients receive the best care at an affordable price. Our doctors work directly with us, and we have negotiated their doctor fees to help lower your bill.

Additionally, we provide the highest Affordable Care Act (ACA) discount to those who qualify. We offer ACA discounts to the under-insured and un-insured (cash pay) on a case-by-case basis, speak to our Patient Advocate to see if you are eligible for this discount.

Our mission is to save lives; our commitment is to protect your bank account by helping you in any way we can to make you physically and financially healthy.

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Emergency Care Coverage

Texas State law requires insurance companies to pay for emergency care at the insured’s in-network benefit level.

“Both Federal and State law recognizes the “prudent layperson standard” in determining what the patient feels is an emergency.

Prudent Layperson Standard states the following:

The term “emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:

  • Placing the health of the individual
  • (or, in the case of a pregnant woman,
  • the health of the woman or her unborn child)
  • in serious jeopardy.
  • Serious impairment to bodily functions, or
  • Severe dysfunction of any bodily organ or part
  • Serious disfigurement

Texas Department of State Health Services

 

Per Senate Bill 425, which took effect September 1, 2015, House Bill 3276, which took effect September 1, 2017, and House Bill 2041, which took effect September 1, 2019, and relates to health care information provided by and notice of fees charge by Freestanding Emergency Medical Care facility, we are required to post a sign stating:

 

This is a freestanding emergency medical care facility.

 

This facility charges rates comparable to a hospital emergency room and may charge a facility fee provider network.

 

This facility or a physician providing medical care may be an out of network provider for the patient’s health benefit plan.

 

The physician providing medical care at the facility may bill separately from the facility for the medical care provided to a patient.

 

This facility is an out of network provider for all health benefit plans.

Per Senate Bill 2038, Freestanding ERs are required to publicly share testing charges or vaccinations for an infectious disease when a state of disaster has been declared.

View Fees

 

It is important to note that the out-of-pocket costs to a patient may differ from the prices in these lists because:

  • Your physician may end up ordering other procedures, more testing, or utilizing additional drugs or supplies during the actual surgery, so the cost of the procedure may be different than what is shown.
  • Your insurance may negotiate rates with our health system, and your particular plan design and where you are at during the year with regards to your deductible and out-of-pocket maximum can largely affect what you will be expected to pay out-of-pocket for your visit.
  • If you do not have insurance, are underinsured, or if paying the full amount for treatment would cause financial significant difficulties, please contact us for financial assistance options, which may reduce the out-of-pocket costs for your visit.
  • Revision date: July 2022

Patient Advocate

Our hospital provides a Patient Advocate to help answer any questions regarding your healthcare benefits and coverage, as well as process claims and disputes on your behalf.

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