Saint Alphonsus Health System

Insurance FAQ

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.