Frequently Asked Questions

Frequently Asked Questions

 

Frequently Asked Questions:

Insurance Questions

When do I make a co-payment or deductible payment?

Most insurance companies require patients to pay a portion of their doctor’s visit or hospitalization costs. This is called a co-payment, co-insurance or deductible. This payment can be made on the same day as the visit or you can meet with one of our credit/collection specialists to discuss payment arrangements.

I have surgery scheduled soon. How do I know if it will be covered?

Many insurance plans require prior authorization (also known as a pre certification) for different types of services. When these services are scheduled we check to see if a prior authorization is required. If the prior authorization is not approved we notify the patient prior to the service taking place. Patients who decide to proceed with the service are responsible for the payment.

My primary care physician wants me to see a specialist. How do I know I’ll be covered?

You should check with your insurance. Most HMOs (health maintenance organization) require you to have a referral before they will cover a visit to a specialist.

What does “adjustment” mean?

“Adjustment” refers to the portion of the bill that your hospital or doctor has agreed not to charge you.

What is the difference between observation and inpatient status?

Observation status means that you will be closely monitored by clinical staff for 24-48 hours. This period determines if you can be sent home or if you should be admitted as an inpatient. This type of visit generally means that you do not require the level of services provided in an inpatient setting.

Inpatient status means that you have been admitted for numerous days and will receive continuous general nursing services.

Observation vs. Inpatient status for Medicare Patients

If you are a Medicare patient, observation status is not considered a hospitalization and is not covered by your Medicare Part A benefits. Observation is covered by Medicare Part B which means that your Medicare Part B Deductible and co insurance will apply.

If admitted to the hospital as a inpatient your hospitalization will be covered by Medicare Part A and you will be responsible for the Medicare Part A deductible.

I don’t have health insurance what are my options?

Please contact one of our credit collection specialists at 989-912-6237 or 989-912-6460 to discuss your options.

I received a letter from my insurance requesting injury details. Do I have to fill this out?

Yes. Your insurance will not process/pay your claims until they receive this back from you. This form is so they can decide who is financially responsible for that bill, your health insurance, house insurance, auto insurance, etc.

 

Billing Questions

Will I receive one bill – or separate bills – for the care I receive at Hills & Dales General Hospital or any of the clinics?

You will receive one guarantor statement on a monthly basis that will list out all charges for you and any dependents such as children under the age of 18.

EXCEPTION: If seen at the hospital for any services you will receive an itemized statement as soon as the insurance has processed the claim. You will not receive an itemized statement for any clinic visits. If you would like an itemized statement for a particular visit please feel free to call the billing office.

How do I make a payment?
  • Cash
  • Check
  • Money order
  • All major credit cards
  • Payments can be either mailed in or you may call the hospital and make a payment over the phone with a credit card.
Can I pay my bill online?

At this time you are not able to make a payment online. We are currently working on it and anticipate being ready for online payment this Spring!

Can I pay a Covenant bill at Hills & Dales General Hospital?

You are not able to pay your Covenant bill at Hills & Dales General hospital. We are affiliated with Covenant however all of our billings and finances are kept separate.

I was told my visit would be covered so why did I still receive a bill?

Please note that “covered” does not mean the same thing as “paid”. Your insurance may cover a visit/test however you may still be responsible for a portion or the entire bill if you have not met your deductible or if you have a co-pay or co-insurance.

What is coordination of benefits?

Do you have more than one health insurance plan? If so these plans need to work together to ensure you are getting the most out of your coverage. One plan becomes your primary plan and makes payment on a claim first. The second plan pays toward the remaining cost. This process is called coordination of benefits.

How can I ensure a smooth billing process? We encourage you take the following steps to ensure a smooth billing process.
  • Bring your most recent insurance cards and your picture ID to every visit
  • Double check that we have the correct address and phone number on file for you
  • Check with your insurance plan to see what is covered and what is not.
  • Confirm with your health insurance that Hills & Dales General Hospital and its clinics is a contracted provider with your insurance.
  • Know what is expected from you in regards to payment such as do you have a deductible? Do you have an office copay? If you are able to make a payment at the time of service please do so. If not contact one of our credit/collection specialists to set up a payment plan or see what options are available for you in regards to financial assistance.
If I am unable to make full payment immediately, can I set up a payment plan?

Yes, please contact our Credit and collections department at 989-912-6237 or 989-912-6460 to establish a payment plan.

Who should I contact with questions about my billing statement?

If you have questions, need to update your insurance information, or would like an itemized bill please contact our credit and collections department at 989-912-6237 or 989-912-6460.

What if I have a question in regards to charges or how my claim was processed?

Please call the hospital at 989-872-2121 and ask to speak to someone in the patient accounting department.

Why am I receiving a bill so late after my visit?

Occasionally when we send a bill to your insurance company for payment they have additional questions or are requesting the doctor’s notes from your visits. Please keep in mind that an office visit may pay quickly but hospital visits are much more complicated and require more time to review.

 

Financial Assistance

Is financial assistance available?

Yes, financial assistance is available. For more information please contact our credit collections department at 989-912-6237 or 989-912-6460.

How do I apply for financial assistance?

Click HERE to download a Financial Assistance application. You may also call 989-912-6237 or 989-912-6460.

If you apply you will receive a letter within 14 business days explaining if you qualify and at what level.

Note: we do require a copy of your last paycheck, current Federal Income Tax Return and a copy of a Medicaid denial if applicable. For more information contact our department.

If I qualify for financial assistance, will I need to re-apply at some point?

Yes. You will be asked to reapply every 90 days. You will also be required to reapply if your family income changes.