Pacific Prime Emergency Medical Facility Guide

How is the Payment
Handled?

1. Outpatient Emergencies
   (no hospital admission)

   

   • This would work the same as any outpatient treatment.
     • Emergency facility within your Network – Direct billing
     • Emergency facility outside your network – Pay and claim (reimbursement)

2. Inpatient Emergencies (hospital admission needed)

   

   • An upfront payment or deposit is likely to be requested whether the facility is in your insurer network or not.
   • Any funds you pay will be reimbursed up to the normal limits of your plan.
   • Pre-authorization is not required for emergency hospital admission, though you must inform your insurer within 48 hours of admission.