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Provider Manual

Emergency Room Services

Last Updated on May 21, 2020

Family Health Center applies a $30 copay for covered emergency room services. The copay is applied on the facility claim. The patient is responsible to pay the $30 directly to the facility.

 

Family Health Center covers the following emergency room (ER) services:

  • ER services from a FHC contracted provider as long as the services do not fall in to the list of non-covered services

Non-covered services – will be denied to the patient:

  • ER services from a provider who is not FHC contracted
  •  ER cardiac cath lab
  • ER/outpatient hospital surgical services
  • ER services when the visit results in:
    • Inpatient hospitalization
    • Observation care
    • Extended Recovery Room