FREQUENTLY ASKED QUESTIONS

ABOUT MY BILL

ABOUT MY INSURANCE

MEDICARE AND MEDICAID PATIENTS

PAYMENT OPTIONS

 

What kind of bills will be sent to me?

University Hospital will bill you and/or your insurance company for all hospital charges you incurred while you were a patient at the hospital.

You will receive separate bills (in addition to your hospital bill) from physicians and/or physician groups, if you received any of the following services while at University Hospital:

If you receive one of these bills and you have insurance that covers these charges, you will be responsible for contacting the appropriate service in order to have your insurance filed for you.

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Will you bill my primary and secondary insurance companies?

You will need to provide us with complete primary and secondary insurance information, including the correct order and insured name for billing.  Once payment is received from your primary insurer, University Hospital will forward the balance to the secondary insurer for payment.

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Can you explain my hospital bill?

The Hospital is responsible for submitting bills to your insurance company and will do everything possible to get your claim processed quickly. However, your policy is a contract between you and your insurance company, and you have the final responsibility for payment of your hospital bill. You are encouraged to contact your insurance company to ensure they have the necessary information and forms to process your claim for payment.

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Why did I receive a bill from a physician I never saw?

If you have certain tests or treatments in the hospital, you may receive statements from physicians you did not see in person.  These bills are for professional services rendered by these doctors in diagnosing and interpreting test results while you were a patient.  Other specialists perform these services and are required to submit separate bills.  If you have any questions about these bills, please call the number printed on the statement you receive.

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Why did I receive two bills when I was treated at the clinic?

When you are seen at the doctor’s private office your charge is made up of two parts:  the professional component (doctor’s time) and the technical component (office space and affiliated personnel).  These two components are billed together in this setting.

When you are seen at University Hospital in a clinic setting the same two components are separately billed.  The doctor will bill for his time and the hospital will bill for the technical component.

Although the doctor comes here to treat patients, this is not the doctor’s office.  Therefore, in order for the Hospital to recover the costs we incurred for the use of our resources, we must bill you separately.  It may be helpful for you to know that insurance companies process physician visits differently depending on whether they are at the hospital or in the doctor’s office and many cover this charge.

We understand this may be confusing; therefore, if you have any further questions, please contact Heather McDavitt at (502) 562-3242.

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If I have commercial health insurance or Medicare coverage, will University Hospital still send me a bill?

Once you have provided University Hospital with the necessary insurance information the hospital will send a bill directly to your insurance company.  You should contact your insurance company to find out whether you will need to fill out any insurance claim forms. [back to top]

What is required if I have health insurance?

We will need a copy of your insurance identification card.  In addition, we may need the insurance forms that are supplied by your employer or the insurance company.  You will be asked to assign benefits from the insurance company directly to the Hospital.  If your insurance company has not paid within 60 days from the date of service, the Hospital expects you to contact them to prompt their payment.  Insurance balances remaining unpaid become the responsibility of the patient[back to top]

If I have health insurance, do I need to pay for any of my hospital bill?

You will be responsible for paying the amount of the bill that is not covered by your insurance company, including any deductibles, co-insurance and co-payments.  Any deductibles, co-insurance or co-payments are due at the time of registration and are to be paid at the point of service. [back to top]

If I already have a Medical Assistance card, will I receive a bill?

Once you have presented your card to the Admissions/Registration personnel or the Business Office, you should not receive any hospital bills.  Exception:  If you are responsible for payment of a spend-down, you will be responsible for that amount.  KenPAC places some restrictions on the use of hospital services. [back to top]

What if I am a member of an HMO or PPO?

Your plan may have special requirements, such as a second surgical opinion or pre certification for certain tests or procedures.  It is your responsibility to make sure the requirements of your plan are met.  If you plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital.  Some physician specialists may not participate in your health care plan, and their services may not be covered. [back to top]

What is the difference between an HMO and a PPO?

Health Maintenance Organizations (HMOs) require a patient to select a primary care physician to coordinate his or her care.  Most HMOs provide care through a network of hospitals, doctors and other medical professionals whom (as a patient) you MUST use to be covered for that service.  Preferred Provider Organizations (PPOs) provide care through a network of hospitals, doctors and other medical professionals.  When patients utilize health care providers within the network, they receive a higher benefit and pay less money out of their pocket.  Services provided by a non-participating hospital or doctor may still be covered, but often at a reduced benefit level. [back to top]

How do I know if my health plan includes University Hospital?

University Hospital participates in most major health plans in Kentucky.  However, you should review your health plan provider directory and/or consult with your plan to confirm coverage. [back to top]

What does “in-network” and “out-of-network” mean?

If you receive your health care services from a hospital, physician or other health care provider that participates in your health plan, they are often referred to as “in-network.”  Hospitals, physicians or other health care providers who do not participate in your health plan may be referred to as “out-of-network.” [back to top]

How do I know if my health plan requires a referral or pre-certification for service?

Your benefit book or provider directory should provide this information for you.  If not, call the customer service phone number listed on your insurance identification card. [back to top]

What should I do if my health plan includes University Hospital as a participating provider, but I receive an explanation of benefits stating I am out-of-network?

Consult your health plan.  If you have further questions about your University Hospital account, you may also contact our Patient Financial Services Customer Service Team by calling (502) 562-3226. [back to top]

What if I am covered by Medicare?

We will need a copy of your Medicare card to verify eligibility and process your Medicare claim.  You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations, and many preventive and diagnostic procedures.  Deductibles and co-payments also are the responsibility of the patient and due at the time of service.  For more information regarding Medicare coverage, you may access their web site at https://www.cms.hhs.gov/coverage/[back to top]

What happens if I have both Medicare and supplemental insurance?

If you have both Medicare and supplemental health insurance, Medicare is the primary payor and the supplemental health insurance is the secondary payor.  In most cases, the supplemental insurance pays the remaining balance of covered Medicare services.  You should check with your insurance provider to find out what coverage you have.  If a Medicare recipient has other coverage through their employer or their spouse’s employer, this coverage may be primary. [back to top]

I am covered under Medicare. Should I call for a price estimate?

If this is a question about a covered service, you do not need to call for a price estimate because University Hospital has a contract to accept Medicare rates for reimbursement.   You will still be obligated for any co-insurance or deductibles.  Most Medicare supplements pay the co-insurance.  If you have supplemental insurance, you should check with your provider to find out what coverage you have. If this is a question about a non-covered service, you should call for an estimate.  Your doctor will be able to tell you if this is a covered or non-covered service.  [back to top]

What is the difference between Part A Medicare and Part B Medicare?

Part A Medicare covers inpatient services and Part B Medicare covers outpatient services. .  For more information regarding Medicare coverage, you may access their web site at https://www.cms.hhs.gov/coverage/[back to top]

What is an MSP and why do I need to provide this information?

MSP stands for Medicare Secondary Payor and is a questionnaire required by Medicare to be completed by you before Medicare will process your claim for payment.  This form may be confusing, so if you do not understand the questions Medicare is asking, you may contact one of our Customer Service Specialists at (502) 562-3236 or (502) 562-3227 or toll free at 1(800) 891-0947, ext. 3236 or ext. 3237 between the hours of 8:00 a.m. and 4:00 p.m. EST for assistance.  This form is available on line by clicking on the MSP link (click here). [back to top]

I was previously a patient at University Hospital and filled out an MSP questionnaire. Why do I have to fill out another one?

It is a Medicare requirement that a new MSP questionnaire be filled out for each claim before it can be processed for payment.  This form is available on line by clicking on the MSP link (click here). [back to top]

What if I am covered by Medicaid?

We will need a copy of your Medicaid card.  Medicaid has payment limitations on a number of services and items.  For more information regarding Medicaid coverage, you may access their web site at https://www.cms.hhs.gov/coverage/[back to top]

I am covered under Medicaid. Should I call for a price estimate?

If this is a question about a covered service, you do not need to call for a price estimate because University Hospital has a contract to accept Medicaid rates for reimbursement.   You will still be obligated for any co-insurance or deductibles.  If this is a question about a non-covered service, you should call for an estimate.  Your doctor will be able to tell you if this is a covered or non-covered service. [back to top]

I belong to a managed care plan. What should I do before coming to University Hospital?

Read your insurance plan booklet to be sure you have followed all the guidelines for referrals and authorizations, or call your insurance company for assistance.  Failure to follow your plan requirements may result in greater out-of-pocket expenses for you.  Your primary care physician plays a very important role in this process.  If you receive a verbal authorization number, please provide us with this information at registration. [back to top]

What if I don’t have insurance?

University Hospital can assist you in several ways.  A Hospital representative will discuss financial arrangements with you.  A representative is also available to assist you in applying for Medicaid or other government assistance programs.  If you do not qualify for any type of government program, a representative can review your financial status to see if you qualify for the Hospital Quality Charity Care Trust (QCCT).  Application forms and information are available on line by clicking on the QCCT link (click here). [back to top]

How will I find out if I’m eligible for financial assistance?

Complete the QCCT application and return it to the Business Office located in the MedCenter One Building at 501 E Broadway, Louisville, KY  40202.  Review of your application will take approximately 30-45 days.  We will contact you as soon as our review is completed.  A completed application is a required step in the determination process for financial assistance.  If you have no income, you will need to provide a notarized statement from whomever you are living with to verify you have no income.  Notarized statements are available online by clicking the notarized statement link (click here). [back to top]

What payment options does University Hospital offer?

There are several options to pay the balance of your account.

  • Payments may be sent to University Hospital, P.O. Box 70115, Louisville, KY  40202
  • Payments may be made by credit card or debit card over the phone by calling the Cashier Department at (502) 562-3128.  (University Hospital accepts VISA, MasterCard, American Express and Discovery credit cards.  University accepts debit cards with a VISA or MasterCard logo.)
  • Payments may be made in the Cashier Department Monday thru Friday from 8:00 a.m. to 5:30 p.m.
  • Payments may be made in the Cashier Department on Saturday and Sunday from 8:00 a.m. to 4:00 p.m.
  • Payments may be made on line by clicking on the pay my bill link.

University Hospital will work with patients to reach reasonable accommodations for payment arrangements by calling the Business Office at (502) 562-3226 between the hours of 8:00 a.m. and 4:00 p.m. EST.

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How will a payment plan be established?

Payment plans are established on an individual basis by discussing your situation with a Business Office representative at (502) 562-3226 between the hours of 9:00 a.m. and 4:00 p.m. EST.  Your minimum monthly payment will be based on your balance.  Your minimum payment must ensure that your balance will be paid in full within the allowed payment plan period. [back to top]

What happens if I don’t pay my bill?

University Hospital makes every effort to assist patients in applying for available programs to help with payment of your account.  In order to hold costs down, we request that all patients do what they can to resolve their balances.  As a final resort, the Hospital will turn over unpaid bills to a collection agency for resolution.  Bad debt accounts are listed with the credit bureau. [back to top]

Why is this billed as an outpatient service when I spent the night at the Hospital?

The physician’s written order dictates whether we bill as an inpatient or outpatient.  For an account to be billed as an inpatient service there must be a physician order.  The physician who ordered your services determined that your condition did not meet the requirements for an inpatient admission. [back to top]

Why did my insurance company deny the claim?

Your insurance company may deny a claim based on one or more of the following reasons:

  • You did not provide the correct insurance information at the time of service.
  • The service you received was from a physician outside your plan’s network.
  • You were not covered by your plan at the time of service.
  • Services you received are not specifically covered by your insurance.
  • Other – contact your insurance company for specific information regarding your account.

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Why do I have a balance after my insurance paid?

This could be your co-insurance or deductible portion.  Your balance is the amount the Hospital was told is due from you as patient responsibility on the explanation of benefits. [back to top]

Why did my insurance company leave such a large balance?

You will need to refer to your insurance plan booklet and/or contact an insurance company representative for specifics on payment. [back to top]

Who do I contact regarding my bill or a change of address?

Our Patient Financial Service/Customer Service Representatives are available by phone at (502) 562-3226 Monday thru Friday from 9:00 a.m. to 4:00 p.m. EST.  If you would like assistance in person, our office is located at MedCenter One Building, 501 E Broadway, Louisville, KY  40202.  Representatives are available to speak with you in person Monday thru Friday from 9:00 a.m. to 4:00 p.m. EST.  You may also e-mail us at sheilade@ulh.org.  Please note that e-mail is not a secure method of communication.  You should not e-mail any confidential information using this address.  Be sure to include your name, account number and telephone number(s) where you can be reached if we have a question. [back to top]

How can I obtain a copy of my itemized bill?

You may call (502) 562-3226 to request an itemized bill.  One will be mailed to your home address within 24 hours. [back to top]

Can I have someone else discuss my account with the Hospital?

Due to the American Health Insurance Portability and Accountability Act (HIPAA) the Hospital is not allowed to discuss your account with a third party without your written consent.  If you would like to have a representative of your choosing discuss your account, you may request a consent form from the Business Office at (502) 562-3226 or download the form by clicking on the HIPAA consent form link (click here).  For more information regarding HIPAA, you may access their web site at https://www.cms.hhs.gov/coverage/[back to top]

What are self-administered drugs?

Self-administered drugs are medications given to you at the hospital that are taken by mouth.  Also included are any medications you were given at discharge to take home.  Many health plans do not cover these items. [back to top]

What is meant by patient convenience items?

Patient convenience items may include any or all of the following:

  • Toothbrush/toothpaste
  • Slippers
  • Water pitcher/cup
  • Urinals
  • Shaving kits

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Who should I call for a price estimate?

Price estimates may be obtained by calling the Business Office at (502) 562-3245 or (502) 562-3631 Monday thru Friday from 8:00 a.m. to 4:00 p.m. EST. [back to top]

Why is the amount I was billed different from the estimate I received?

The amount you were quoted was for the standard base rate for the service you requested.  Since all charges are dependent upon services ordered by the attending physician based on individual patient needs, the final amount billed may be more or less than the estimated price quoted prior to treatment. [back to top]

How do I have someone check charges I don’t believe are accurate or are for services I don’t think I received?

You should call our Customer Service line at (502) 562-3226 or e-mail sheilade@ulh.org.  When e-mailing, be sure to include the patient name, medical record number and date(s) of service.  The Hospital will forward your question to one of our internal auditors to review the charges against the medical record.  You will receive a reply within 10 business days. [back to top]