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Prudent Layperson Standard

The ER on Soncy understands the rising costs of healthcare and complicated health insurance rules and regulations are very confusing and frustrating.   Our Physicians and staff are experts in treating medical emergencies.    We are passionate about treating patients,  not symptoms.  Our passion and expertise provide each patient with the  BEST  emergency care available.  Our goal is to help you understand your insurance benefits, our billing process, and provide an easy and understandable explanation from our staff.   If you have any questions about your care, insurance, explanation of benefits (EOB), or the billing process, please contact us 806-340-0608 and ask to speak to one of our patient advocates.

The Truth About Emergency Room Billing:

Your insurance company is required by law to process all ER claims as in-network. Your emergency visit at The ER on Soncy is to be paid based on your in-network benefits, regardless of our relationship with your insurance company. This safeguards you so you are not searching for an in-network provider when you need care now.

Insurance Code Law

S.B. 1264, 86th Legislature

Sec. 1301.155.  EMERGENCY CARE.  (a)  In this section, “emergency care” means health care services provided in a hospital emergency facility, freestanding emergency medical care facility, or comparable emergency facility to evaluate and stabilize a medical condition of a recent onset and severity, including severe pain, that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that the person’s condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in:

    • (1)  placing the person’s health in serious jeopardy;
    • (2)  serious impairment to bodily functions;
    • (3)  serious dysfunction of a bodily organ or part;
    • (4)  serious disfigurement; or
    • (5)  In the case of a pregnant woman, serious jeopardy to the health of the fetus.
  • (b)  If an insured cannot reasonably reach a preferred provider, an insurer shall provide reimbursement for the following emergency care services at the preferred level of benefits until the insured can reasonably be expected to transfer to a preferred provider:


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