If you don’t see the answer to your billing question below, visit our billing office, call (877) 673-0903 or inquire online at the link below.
Billing InquiryShould I bring my insurance card and picture ID with me?
Yes, the information on your insurance card is needed to file a claim with your insurance company or companies. When you register we will ask for information about your insurance coverage.
You should also be aware that your insurance card contains important information about the co-pay amounts you are responsible for on different types of services. If possible, please be sure to review your health insurance handbook or website prior to your trip to the hospital.
We’re required to look at your picture ID to help prevent identity theft and establish that we have the correct patient and the correct medical chart. Obtaining your previous medical information is vital to taking good care of you.
Remember, the registration process goes much faster when you bring complete insurance information with you.
Do I have to pay my co-payment at the time of registration?
Yes, you are expected to pay your co-payment when you register. Your insurance card should indicate the dollar amount of the co-payment required for each type of service. If you have questions regarding co-payment amounts, please contact your insurance company, your employer, or your health insurance handbook or website.
How will I know if a service is covered by my insurance?
Many health insurance plans cover all or part of your medical charges, but policies vary widely in terms of which procedures, services, or items an insurance company will cover. Because policies are often customized, we do not always know what your policy covers. To maximize your health insurance benefits, it is very important that you familiarize yourself with the policies and benefits outlined in your handbook or website.
Questions to ask your insurance company:
- Am I covered for (service/item name)?
- What are my benefits for (service/item name)?
- Do I need a referral or prior-authorization from my primary care doctor for (service/item name)?
- Is the clinic/hospital/provider I’m going to a participating / in-network provider? If not, how will that affect what I have to pay?
How will I know if my insurance company has paid my bill?
Your insurance company is responsible for sending you an explanation of benefits (EOB) when it pays your hospital bill. You should usually receive this from your insurance company before you are billed by your provider. If you have any questions regarding any information on the EOB, please call your insurance company for details. The hospital/clinic billing office will receive information from your insurance company regarding how much they paid, and how much we are to bill you. But many times, the information we receive from the insurance has different details than the information you receive.
What is Pre-authorization and what does this mean?
Pre-authorization is the approval by your insurance company to proceed with surgery or a special procedure. Many procedures or surgeries require pre-authorization from your insurance. You must verify that this is done by the physician who will perform the procedure. Obtaining pre-authorization does not guarantee that your insurance company will pay the bill.
Can I see an itemization of my charges?
Any time you want to see an itemization of your specific charges, please call the billing office and they’ll be more than happy to mail this to you. In keeping with industry standards in an effort to be environmentally responsible, we provide a summary statement to all patients and an itemization at any time upon request.
When is my annual “wellness” visit covered and what does it cover?
Most insurers now cover an annual “wellness” visit every 12 months. However, please be aware of two things: 1) If during your exam, an unexpected illness or condition is presented that needs attention and/or treatment by the provider, it is no longer considered a “wellness” exam, and your regular copays and deductibles will apply. You can then re-schedule your annual wellness visit. 2) Only the provider visit is considered your “wellness” exam. That does not include any ordered tests. Most insurers pay for very few “screening” diagnostic tests as a part of wellness visits. You should check with your insurance regarding which screening tests are covered and how often. Then you may want to obtain an estimate on the other screening tests ordered during your wellness visit.
Hospital Bill Complaint Program
The Hospital Bill Complaint Program is a state program, which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.
Help Paying Your Bill
SoHum Health offers Charity Care, Financial Assistance, Payment Plans, and Discounted and Extended Payment Plans for those who are eligible. For more information about this program and how to apply visit the Help Paying Your Bill page.
There are also free consumer advocacy organizations that will help you understand the billing and payment process. You may call the Health Consumer Alliance at 888-804-3536 or go to healthconsumer.org for more information.
If you didn’t see the answer to your billing question, visit our billing office, call (877) 673-0903 or inquire online at the link below.
Billing Inquiry