Billing and payment

We encourage you to check with your insurance company or your employer about this. Because there are so many types of insurance plans, it is difficult for us to determine if you need prior approval or notification for your hospital stay. Contacting your insurance company or your employer with specific questions about what is or is not covered by your insurance plan can help avoid confusion later. This is also a good time to verify your insurance co-pay obligation. Ultimately, Atlantic Health relies upon each patient to know his/her insurance policy’s rules and regulations.

When making medical payment decisions, make sure you know:

• The total costs
• What your insurance will cover
• What you will have to pay out-of-pocket
• What method of payment the hospital accepts
• If you or your hospital physician's office staff will be completing insurance forms

• A deductible is the initial amount of "covered" health costs that you pay before your insurance plan begins reimbursement. A deductible is usually a set dollar amount such as $250 or $500.
  
  
• A copayment is the portion of your health care expenses not covered by insurance. A co-payment is usually a percentage figure, like 10% or 20%.

For example, on a $500 bill, your deductible might be $150, so you would have to pay the first $150. This leaves a balance of $350. Of that $350, your co-payment might be 20%, meaning that you will have to pay an additional $70. Your insurance company will pay the remaining $280.

Once you have this information, there may be a number of ways to pay your bill:

• If your insurance pays all but a deductible or copayment, you will be required to pay an estimate of your portion of the bill at the time of service.
  
  
• The hospital will file the claim for you. After insurance has made payment, you will receive a bill asking for payment on the balance using cash, check, or credit card.
  
  
• In certain circumstances, you will be able to make monthly payments to the hospital until your bill is paid in full. You should discuss this with our Patient Accounts Department.

Make sure that you understand what the hospital requires and what payment options you have.

You will receive a bill from the hospital if your insurance company informs us that there is a patient responsibility or if your insurance company fails to pay the hospital in a timely manner.

Yes, we will submit your bill to your insurance company. If for some reason we are unable to submit your claims to the insurance company for you, we will inform you immediately.

In addition to your bill from the hospital, you may receive bills from other physicians who may have provided services to you. For instance, you may receive bills from consulting physicians, radiologists, or other specialists. Please contact their office directly if you have questions concerning their bills.

The hospital will bill your insurance company directly (unless you specify otherwise). You are ultimately responsible for making certain that your bill is paid.

If a balance remains after your insurance has issued a payment or a denial, payment is due immediately upon receipt of your statement.

After your insurance company has paid its portion of your hospital bill, it should send you an explanation of benefits. This indicates the amount that has been paid by the insurance company and any portion of your balance you are required to pay. If there is a patient responsibility, such as a co-payment, coinsurance or deductible, you will receive a bill from the hospital. Payment is expected upon receipt of the bill. If you are unable to pay the entire balance, payment arrangements can be made by contacting the business office.

Please contact your insurance company directly for this information.

Before you call, have available:

• Your health insurance card
• The date(s) of service
• Original billed amount
• Claim/account number if available

If you are told your bill was already paid, ask when that was done and to whom payment was made. Please document this information and the name of the person you spoke with at the insurance company for your records.

If the bill has not been paid, ask when the anticipated time frame of payment is, and ask if anything else is needed from you.

If the bill isn't paid within the stated time frame, follow-up with the insurance company again, and, if necessary, request to speak to a supervisor.