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Patient and Visitor Services : Billing and Insurance

Q. Who is responsible for paying my hospital bill?

A. The patient is the guarantor (person responsible for paying) for the bill. However, if the patient is a minor, the parent/guardian is listed as the guarantor. Many people who have insurance assume that their insurance company is responsible for paying for the services received at the hospital. This is not necessarily true. If the hospital is unable to settle a claim with the insurance company, the patient/guarantor may be billed. It is the guarantor’s ultimate responsibility to ensure the bill for services provided is submitted to the insurance company and resolved.

Q. Will St. Francis Hospital bill my insurance company?

A. St. Francis Hospital bills most insurance companies directly as a service to our patients. You will be asked to sign a form allowing direct payment to the hospital.

Q. Will I need to supply proof of my insurance?

A. At registration or upon admission, you will be asked to provide your insurance information, and a driver’s license or picture identification. You should also provide referrals or authorization forms that may be required by your policy. Supplying old or incomplete insurance information as well as not bringing the required authorization forms could result in hospital charges being billed directly to you.

Q. How do I know if my benefits will cover a service?

A. We suggest that you contact your insurance representative for an explanation of your benefits. As a patient, you are responsible for knowing whether or not St. Francis Hospital is a preferred provider of your health services beforehand. Unfortunately, many people receive unwelcome surprises when the bill arrives because they are not familiar with their insurance coverage. By contacting your health insurance company before anyone in the Family gets sick or receives care, you will know the benefits and limitations of your insurance policy.

Q. What charges, if any, will I have to pay?

A.  You are responsible for paying for any services received during your hospital stay that are not paid by your insurance company, including co-payments and deductibles. You can expect a notice or explanation of benefits from your insurance company indicating the ount to be paid to the hospital. If you should disagree with any ount not paid by your insurance company, you should contact your insurance company directly. Please note that the insured person is responsible for appealing any payment discrepancy or disputing non-payment with the insurance company directly.

Q. What type of payment does the hospital accept?

A. St. Francis Hospital accepts cash, checks, money orders, Visa, MasterCard, American Express and Discover. A cashier is available in the main lobby of the hospital Monday through Friday (except holidays) from 9 a.m. to 4 pm

Q. What if I  am on a fixed income and can’t pay my bill all at once or I don’t have insurance?

A. If you need to make special payment arrangements for charges not covered by your insurance, please call the phone number noted on the bill, and a representative will assist you.

Q. What if I have questions about my bill?

A. You can call the phone number noted on the bill, and a representative will assist you.

Q. What if I cannot afford to pay my hospital bill?

A. If you are experiencing financial hardship and need help paying your hospital bill, you may qualify for the hospital’s Financial Assistance Progr. Financial assistance is available for healthcare services that are medically necessary (excluding cosmetic surgery, fertility treatments and prescriptions). Eligibility is based upon household income, expenses and dependents. You can make arrangements to pay your bill by calling the number noted on the bill and a representative will assist you.

Q. What does “managed care” mean?

A. Many filies belong to a managed care plan called a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). If you have selected this type of insurance coverage, you must have approval before receiving hospital services. Most plans require a separate authorization for laboratory, radiology, electrodiagnostic testing (EKG), emergency services and other outpatient procedures. Only your primary care physician may authorize these services under the HMO/PPO plan to ensure payment to St. Francis Hospital.

Q. Will my company pay for my emergency room visit?

A.  If your primary care physician instructs you to go to St. Francis Hospital for emergency services, this does not necessarily mean the insurance company will cover the charges incurred. The best time to find out how your insurance company defines “emergency” is before the situation arises.