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### Facility Notice & Insurance Information

## HB 2041 Facility Notice

This facility is a freestanding emergency medical care facility.
This facility charges rates comparable to a hospital emergency room and may charge a facility fee.
This facility or a physician providing medical care at this facility may be an out-of-network provider for the patient’s health benefit plan provider network.
The physician providing medical care at this facility may bill separately from this facility for the medical care provided to a patient.
This facility is an out-of-network provider for all health benefit plans.

Este centro es un centro de atención médica de emergencia independiente.
Este centro cobra tarifas comparables a las de una sala de emergencia de un hospital y puede cobrar una tarifa de instalacion.
Este centro o un médico que brinda atención médica en este centro puede ser un proveedor fuera de la red para el proveedor del plan de beneficios de salud del paciente
El médico que brinda atención médica en el centro puede facturar por separado de este centro por la atención médica brindada a un paciente.
Este instalación es un proveedor fuera de la red para todos los planes de beneficios de salud.

#### SignatureCare Emergency Center ER Chargemaster List

- Texarkana, TX
- Odessa, TX
- College Station/Bryan, TX
- Midland, TX
- Killeen, TX
- Frisco, TX (Coming Soon)
- Plano, TX (Coming Soon)

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