We continually strive to contain costs, while maintaining our commitment to excellence in medical care, by ensuring that every appropriate effort is made to collect money owed to the hospital for services provided. Bay Medical Sacred Heart will provide care without discrimination for emergency medical conditions regardless of a patient’s ability to pay.
Preparing for Your Visit
Please bring these items with you to the hospital for each visit:
• insurance cards;
• orders, referrals or pre-certification numbers/information from your physician;
• valid driver’s license or state identification card;
• payment for your co-pay, deductible, and any services that are not covered by your health insurance plan
Health Insurance Benefit Plans and Coverage
There is no doubt that health insurance benefit plans are confusing. Most plans do not provide 100% coverage for a hospital bill. Each plan has its own set of rules, exclusions and services that are not covered.
It is your responsibility to be familiar with your specific benefit plan. If you are unsure of your coverage for a particular medical procedure or test, you should call the customer service telephone number on your insurance card before scheduling the procedure.
Your health insurance policy is a contract between you and your insurance company. As a service to you, Bay Medical Sacred Heart will send a claim to your health insurance company. By working together, we can minimize misunderstandings, payment delays and billing costs. However, you are responsible for any charges not covered by your health insurance benefit plan.
Prior Certification and Notification
Depending on your plan, you may be required to get approval (pre-certification) before you receive hospital services. Even in a life-threatening situation, your benefit plan may require you to contact them within 24 hours of receiving hospital care. We will assist you in doing that, but if you don’t obtain approval from your insurance company, you are responsible for paying for your hospital care. Also, obtaining approval does not guarantee that the cost of the service is completely covered by your benefit plan. You will still be responsible for any charges not covered by your benefit plan.
If Bay Medical Sacred Heart does not participate in your insurance plan, you can still receive services here. However, your insurance company will consider our services as “out of network” and you may be responsible for all or a higher portion of the bill than if you obtained services from an in network or participating provider.
Scheduled Direct Admissions, Surgical and Diagnostic Services
You will be contacted by our pre-registration team at least 48 hours prior to your surgery or services to gather demographic and insurance information. We will verify insurance and let you know the patient estimated portion owed for your scheduled services. Pre certification from your insurance plan may be required prior to services. Pre certification is obtained by your primary or rendering surgeon prior to the procedure. A surgical services coordinator may also contact you to discuss pre-surgery instructions and notify you of your required arrival time. We encourage you to pay the estimated portion due at the time of pre-registration to expedite the admissions process and also allow you to leave your valuables at home on the day of the procedure.
We encourage you to pre-register early in your pregnancy so that we can provide an in depth introduction to the hospital and services. Contact our pre- registration department at 800-305-9237 to pre-register. In addition, we will provide you with information regarding your insurance benefits and any patient portion that may be due at the time of delivery. We also offer self pay package rates for mom and newborn.
You will receive separate bills from the physicians (hospitalists, radiologists, anesthesiologists, pathologists, surgeons, etc.) involved in your care. If you have questions or concerns about those bills, call the physician office or the customer service telephone number on your insurance card.
It’s your responsibility to ensure that your health benefit plan meets its obligations to you and pays everything it should. An important step in doing that is to keep every hospital (and physician) bill you receive. Likewise, keep all the documentation sent by your health insurance plan. In this way, you can compare the payments made by your insurance company against your health benefit plan.
Questions About Your Bill?
Patient Financial Services is available to assist you with questions concerning your hospital bill. Call Customer Service at 855-609-0641, weekdays from 8 a.m. until 4:30 p.m. Central Standard Time.