Billing: What a Hospital Bill Covers
The hospital bill covers the cost of your room, meals, 24-hour nursing care, laboratory work, tests, medication, therapy and the services of hospital employees. You will receive a separate bill from your physicians for their professional services. If you have questions about these separate bills, please call the number printed on each statement.
The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company and that you have the final responsibility for payment of your hospital bill.
Most insurance plans now require pre-certification for hospital stays and certain tests and procedures in order for you to be eligible for full policy benefits. It is your responsibility to see that this is completed. This information can be found on your insurance card. If you are unsure of your pre-certification requirements, we recommend that you contact your insurance company as soon as possible.
Coordination of Benefits (COB)
Coordination of Benefits, referred to as COB, is a term used by insurance companies when you are covered under two or more insurance policies. This usually happens when both husband and wife are listed on each others insurance policies, when both parents carry their children on their individual policies, or when there is eligibility under two federal programs. This also can occur when you are involved in a motor vehicle accident and have medical insurance and automobile insurance.
Most insurance companies have COB provisions that determine who is the primary payer when medical expenses are incurred. This prevents duplicate payments. COB priority must be identified at admission in order to comply with insurance guidelines. Your insurance may request a completed COB form before paying a claim and every attempt will be made to notify you if this occurs. The hospital cannot provide this information to your insurance company. You must resolve this issue with your insurance carrier in order for the claim to be paid.
As a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number and the correct mailing address for your insurance company.
If You Have No Insurance
A representative of the Business Office will discuss financial arrangements with you. You may also speak
with a hospital representative from the Social Services Department to assist you in applying for Medicaid or other government-assisted programs. Please let your nurse know if you wish to speak with one of our representatives.
We will need a copy of your Medicare card to verify eligibility and to process your claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments are the patient’s responsibility.
We will need a copy of your Medicaid card. Medicaid has payment limitations on a number of services and items. Medicaid does not
pay for the cost of a private room unless medically necessary.