Headlines across the country are full of healthcare uncertainty these days. But no matter what happens on the national landscape, families are most concerned with their own healthcare and how to manage it. In the event of a medical emergency or necessary hospitalization, one of the biggest worries is how to manage the medical bills. Insurance can be confusing. Here is a quick primer from Fauquier Health on the hospital billing process.
To protect patient health information and provide the most accurate billing services possible, Fauquier Health’s registrars collect and verify demographic and insurance information at every visit. It’s important that Medicare patients know if their primary insurance is Medicare. If it is not, they will be asked to present their most current primary insurance cards, along with their Medicare card, at registration.
Learn about your insurance
Patients can help themselves by knowing, understanding and abiding by the requirements of their insurance plan. Patients should be aware of the major nuances of their insurance, like co-pays, co-insurances and deductibles.
Registration personnel at the hospital work with dozens of different insurance plans. They may not be experts in all of them. Patients should be aware of the specifics of their insurance.
If you don’t know whether or not Fauquier Hospital participates with your insurance, ask at registration. If the hospital or services are not in your network, it may increase your out-of-pocket costs.
Pre-authorizations and referrals
If preauthorization or referral is needed, you should obtain it from the ordering physician prior to coming to the hospital. Preauthorization is not a guarantee that insurance will cover the procedure.
Like all hospitals nationwide, Fauquier Hospital would like to collect all known patient expenses at the time of registration.
Check with your insurance company to learn if your coverage involves a copay or deductible or requires you to pay a percentage of the hospital bill (co-insurance). When you register, you will be given an estimate of the charges based on the information you provide. (There are many variables that could result in a change to the estimate.) You will be offered the opportunity to pay up front and receive a 20 percent prompt pay discount. To get the discount the bill must be paid within seven days of the date of service.
If you cannot pay up front, CarePayment is available for qualifying individuals. These payment plans are at zero percent interest and have longer payment terms.
Your hospital bill
Fauquier Hospital will bill your insurance company on your behalf, usually within one to two weeks after an inpatient discharge or an outpatient visit. After insurance has processed a claim–usually within four weeks–patients will receive a statement from National Patient Account Services (NPAS). The statement will arrive in a plain white envelope, without any return address that would reveal the sender. This is done to keep your health information private.
A NPAS representative will call within 30 days of the statement date if payment is not received, He or she will state that they are representatives of Fauquier Hospital and will ask for certain identifiers, such as a date of birth or address. The first statement will include a summary of charges incurred. Subsequent statements will show only a balance forward.
Uninsured discount program
An uninsured discount program for patients who do not have health insurance is in place. For those who are uninsured, or choose not to use their insurance, the hospital bill will reflect a 38% discount.
Deposit on uninsured scheduled services
Patients who are uninsured and not eligible for financial assistance are asked to pay a 50 percent deposit at the time of the scheduled service. This amount is based on the estimate. (This requirement does not apply to emergency care.)
If you are unable to pay your hospital bill, you can contact an NPAS customer service representative at (800) 223-9899. He or she will work with you to develop a comfortable payment plan, or direct you to a financial counselor at the hospital if you find you need additional assistance.
Financial assistance is available to eligible patients. Financial counselors may be reached Monday through Friday from 8 a.m. to 12 noon, and 1 to 4:30 p.m., at (540) 316-2970.
Fauquier Hospital contracts with a company called MedAssist to help patients who are uninsured or underinsured explore options that are available through federal and state programs. A MedAssist representative may visit inpatient rooms or contact outpatients by mail or phone.
Fauquier Health’s Financial Assistance Policy and the Financial Assistance Application are both located at www.fauquierhealth.org. Search for Financial Assistance.
Other bills you may receive
In addition to your hospital bill, you may receive separate bills from physicians and or other healthcare providers involved in your care. These providers–who might include Emergency Department physicians, hospitalists, radiologists, anesthesiologists, or laboratory or transportation services–handle their own billing. Any questions regarding these bills should be directed to their offices.