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Insurance Frequently Asked Questions
Do I need to inform my insurance company that I'm going to receive
hospital services?
It depends on your insurance policy. It is your responsibility to check with
your insurance company or your employer about whether or not you need prior
approval or authorization before receiving services or as soon as possible
in emergency situations. Saint Alphonsus will work with insurance companies
in emergency situations to do the initial notification of admission. Some insurance
companies require the patient and/or patient's family to also do a notification.
Should I bring my insurance card with me to the hospital?
Yes. The information on your insurance card is needed for
Saint Alphonsus Regional Medial Center to file a claim with your insurance
company. When you register, we will ask you for information about your insurance
coverage and have you sign forms for consent for treatment and assignment of
benefits. This registration process goes much faster when you bring your insurance
information with you or when you pre-register for scheduled services.
How do I find out if my insurance company will cover my hospital services?
Insurance policies vary. Contact your insurance company
or your employer with your specific questions about what is or is not covered
by your insurance plan or if a referral is required. In many
cases only your insurance company will be able to tell you if your services
will be paid at an in-network rate. Medicare does not cover some services.
For example:
- Self administrable drugs for outpatient services
- Inpatient or outpatient dental services in most cases
- Screening tests not specifically listed in the handbook as covered
Please refer to your Medicare handbook to check on
services you will be receiving.
When do I become responsible for my bill?
You are financially responsible for your bill at the time you receive services.
Many insurance benefits include co-payments, deductibles and coinsurance which
are the responsibility of the patient. Please be prepared to pay your portion,
estimated or actual, at the time you receive services. Registration representatives
can provide assistance to estimate total charges as well as explain payment
methods and plans. All account balances are due upon receipt of the bill.
What is a deductible? A co-payment? Co-insurance?
- A deductible is the out-of-pocket amount you must pay before your insurance
plan begins reimbursement. A deductible is usually a set dollar amount, such
as $250.
- A co-payment is usually a set amount you owe per visit or per service.
Co-payments may be associated with hospital admissions, ER visits, physician
services, therapy or other hospital services.
- Co-insurance is the percentage of your covered heath care expenses that
you are expected to pay. It may be in addition to deductible and co-payment
amounts, but usually has an annual maximum amount.
- Payment of deductibles, co-payments and co-insurance is due at the time
of service.
Will you bill my insurance company for me?
Yes, Saint Alphonsus will bill your insurance company based on the information
supplied by you at the time of registration. You may receive requests from your
insurance company to provide additional information they need to complete processing
of your claim.
How will I know if my insurance company has paid on my bill?
Most insurance companies will send an explanation of benefits to the subscriber.
In addition, Saint Alphonsus will send you a statement indicating any payments
received and the amount you are responsible for paying. The account balance is due
upon receipt of your bill.
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