Below are frequently asked questions and their answers related to billing and insurance.
When will I receive a bill?
Bills for services rendered are sent only after all third parties, such as insurance companies, have been billed. If you have insurance and are receiving bills or statements from us, please check to see if your insurance company has paid its portion of your bill. If it has, the balance is likely your co-insurance or deductible.
Why have I received a bill?
The hospital sends a bill to you to keep you abreast of the status of your bill and payments. Please review your statement to ensure charges submitted to insurance companies and payments received are accurate. The hospital will continue to send you a statement until your account balance reaches zero.
Will you bill my insurance company for me?
Yes, as a courtesy we bill your insurance company/companies. It is your responsibility to provide any requested information to your insurance company (accident information, claim forms, other health insurance information, or pre-existing condition information). Insurance claims are generally paid four to six weeks after we have filed your claim.
Why did I receive more than one bill?
If you have received more than one bill, please review them carefully and you will likely find only one is from us. You most likely have received a bill from the physician(s) who saw you at the hospital. Physicians send bills for their services separately from the hospital.
It has been several weeks since my hospital visit. Why haven't I received a bill?
We will always bill the medical insurance on file first. Once the insurance has paid its portion, any remaining amount will be billed to you. Depending on how quickly the insurance carrier processes the claim, it may take anywhere from three to 12 weeks for you to receive a bill.
Why do your rates vary so much?
Our rates are regulated by a state commission and we change them monthly, so our average charge is equal to the rate set by the state commission.
Why does my hospital service cost so much?
In the state of Maryland, MedStar St. Mary's Hospital is one of the most cost-effective medical facilities - a fact we're very proud of! Our rates are regulated by a state commission and are set at a level that covers our cost of providing services. Included in our cost of providing services are costs of charity care and various other community services we provide. We are a not-for-profit organization, so any profits we have go toward keeping future costs of care down and keeping our facility and equipment up-to-date.
Does MedStar St. Mary's Hospital offer financial assistance?
Yes, MedStar St. Mary's Hospital offers a Payment Assistance Program for hospital services to those persons who are determined eligible. If you are eligible, you may receive services at no charge or at a discounted rate.
Does MedStar St. Mary's Hospital accept my insurance?
Please call your insurance carrier directly to ensure that you will be covered.
Should I bring my insurance card with me to the hospital?
Yes, the information on your insurance card is needed for the hospital to file a claim with your insurance company or companies.
I gave my insurance information to my doctor. Why don't you have it?
Physicians are independent contractors to the hospital. Each maintains his or her own patient information. Also, your benefit coverage may be different for a physician than it is for hospital services. For these reasons, physicians and the hospital retain separate insurance information.
How do I follow up with my insurance company?
Most insurance company ID cards have a customer service phone number on the back. Before you call, have available your insurance card, date of service, original billed amount, patient name and claim number, if applicable. Write down the name of the person you talked to at the insurance company. If the bill is not paid in the stated timeframe, follow up with the insurance company again and, if necessary, request to speak to a supervisor.
Other key questions you should ask the insurance company customer service representative include:
- Have you received the hospital's bill for these services?
- Am I covered for these services?
- When will you pay the hospital for these services?
- What portion of this bill will I be responsible for paying?
- What is the status of the account? If paid, ask when and to whom.
Do I need to let my insurance company know I'm going to be in the hospital?
We encourage you to check with your insurance company or your employer regarding coverage. Because there are so many types of insurance plans, we do not know if you need prior approval or notification for your hospital stay.
How do I know if my insurance company will cover my visit or certain services?
Coverage varies with each insurance company. The hospital staff does not know whether a particular service will be covered. Medically necessary and appropriate services may not always be covered by your insurance contract. Please refer to your insurance member handbook or call your insurance company directly with questions.
Why didn't my insurance cover some services?
Insurance policies vary on what services are allowed (paid). Your particular policy may not cover a certain service, or you may not have met your policy's deductible or co-payment.
How will I know if my insurance company has paid my bill?
If there is a balance due from you after the insurance company has paid its portion, MedStar St. Mary's Hospital will send you a statement. This statement indicates the amount that has been paid and any balance you are required to pay. Please call 301-475-6033 for billing inquiries and to set up payment arrangements.