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Frequently Asked Questions about hospital bills

Who do I talk to if I have a question about my bill?

Your billing statement may contain a phone number and name of the person to call if you have questions; if not, call the hospital’s main phone number and tell them you have a question about your billing statement. They will transfer you to the appropriate department.

I do not have insurance but need hospital care. What should I do?

Most hospitals have policies and procedures to help people who do not have insurance. These are sometimes referred to as ‘charity care policies’. It is best to call the hospital prior to your admission to discuss options with them. If it is an emergency and you do not have time to talk with them before you seek hospital care, ask to talk with someone in the business office about your ability to pay as soon as you can during your hospital stay.

Why did I receive more than one bill for my hospital stay?

In addition to the billing statement from the hospital, you may receive a bill from physicians who were involved in your care, such as your surgeon, anesthesiologist, radiologist or pathologist. If you were taken to the hospital by ambulance, you may also receive a bill from them.

Why do hospital charges tend to be higher than the charges from a physician's clinic?

In addition to being available 24/7/365, hospitals operate a number of departments that are both expensive and that generate little or no revenue. Departments such as the Intensive Care Unit and the Emergency Department require equipment, technology and highly trained staff to support their mission to provide life saving procedures and services to all who present to their hospital regardless of ones ability to afford the care they receive. Other supporting departments such as maintenance, environmental services, medical records, etc. also serve as key resources for providing quality patient care and yet do not generate revenue. Additionally, the higher level of care a hospital can provide to patients makes it nearly impossible to accurately compare hospital charges to those charges of a physician's clinic. Hospitals also provide, in large part, charity care for those who are uninsured or underinsured as well as community outreach programming in support of their mission as a not-for-profit organization.

What is the difference between an out-of-network provider and an in-network provider?

Your insurance company negotiates contracts with hospitals and physicians to provide services to their clients at reduced prices. If a hospital or a physician chooses to contract with the insurance company, they are considered an in-network provider and your insurance company has negotiated a discount with the hospital or physician. An out-of-network provider is defined as a hospital or physician who has chosen not to offer a discount to the insurance company. If you choose to use an out-of-network provider, generally the out-of-pocket cost to the individual is higher than from using an in-network provider because the insurance company will not receive a discount from the hospital or the physician and the individual may be financially responsible for the difference.

If you do not have health insurance:

Contact the hospital and ask about its payment policies. Hospitals have charity care policies that offer partial or total fee reductions, or payment plans, to patients who have a financial need. However, hospitals expect patients to cooperate in the eligibility determination process.

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