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Frequently Asked Questions: Billing, Insurance & Medicare
Billing
Insurance
Medicare
Billing
Who can I talk to with questions about my
bill?
Shands Customer Service Representatives are available to help you over
the phone with any questions or concerns you may have about your bill.
Representatives are available Monday through Friday, 8:30 a.m. until
5:00 p.m. Call (800) 342-5364 or (352) 265-0355. Representatives will respond to your inquiry during normal
business hours.
When
will I receive a bill?
If you verified your insurance information when you
registered, you will not receive a bill until:
- Your
insurance company denies the claim
- Your
insurance company pays the claim, leaving a coinsurance,
deductible or non-covered services
- Your
insurance company hasn't responded to the claim
When
do I become responsible for paying my bill?
You are legally responsible for your bill at the time
you receive services from the hospital. We require all
patient balances be paid immediately after you are notified.
What
if I get more than one bill?
You may receive more than one bill for the same hospital
stay. These bills are for services provided by physicians,
anesthesiologists, radiologists or other healthcare
professions. If you have questions about a specific
bill, please call the phone number listed on that bill.
How
can I pay my patient balance?
We offer several payment options:
- You
can pay by cash, check or money order. Make the
check or money order payable to the hospital and
include your account number. Mail to Shands Hospital,
PO Box 31240, Tampa, FL 33631
- You
can choose to use your MasterCard, Visa or Discover
Card. If you have further questions or can not pay
the balance immediately, please call our Customer
Service Department at 800.342.5364 or 352.265.0355
to make arrangements.
Why
can't I pay for my doctor's office visit/bill online?
The billing system for visits to your doctor's office
is different than the hospital billing system. For this
reason, you may receive several bills. At this time,
the billing system for University of Florida Physicians
is not available online.
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Insurance
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. When you register
we will ask for information about your insurance coverage and have you
sign a few forms. This registration process goes much faster when you
bring your insurance information with you.
Do
I need to let my insurance company know that I'm going
to be in the hospital? What will they cover?
We encourage you to check with your insurance company
or your employer about this. Because there are so many
types of insurance plans, it is difficult for us to
tell you whether or not you need prior approval or notification
for your hospital stay. Contact your insurance company
or your employer with specific questions about what
is or is not covered by your insurance plan.
How
do I know if my insurance company will cover my visit
or certain services?
Coverage varies with each insurance company. Generally,
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 with questions.
How
do I know if my insurance company will cover services
provided by all professionals (i.e. anesthesiologists,
radiologists and pathologists) involved with my treatment?
We encourage you to check with your insurance company
or your employer about this. Each professional needs
to contract individually with insurance companies and
the hospital does not know if each professional is contracted
with your insurance company.
Will
you bill my insurance company for me?
Yes, as a courtesy we will bill your insurance company.
It is your responsibility to provide any requested information
to your insurance company (accident information, claim
forms).
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, we will send you a statement.
This statement indicates the amount that has been paid
and any balance you are required to pay. This is your
bill. You are required to pay this bill in full or will
need to contact our office.
How
do I follow up with my insurance company?
Before you call, have available your insurance card,
date of service, facility name, original billed amount,
patient name and claim number if applicable. Obtain
satisfactory status of account. If paid, ask when and
to whom. Note this information and with whom you spoke
to at the insurance company. If the bill has not been
paid, find out when the anticipated payment date is
and ask if they need anything from you. 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.
What
do I do if I disagree with how much my insurance company
has paid on my bill?
If you disagree with the insurance company's payment
amount, contact the insurance company and ask them to
review how the claim was processed. If the insurance
company finds that an error was made, note the information
and whom you talked to at the insurance company. Request
an anticipated payment date and ask if they need anything
from you. If the insurance company feels the bill was
paid correctly and you still disagree, find out from
the insurance company what you need to do to file an
"appeal" with them. Filing an appeal will
not guarantee that the insurance company will pay more
on your bill, but the claim will be reviewed for reconsideration.
Will I be required to pay anything when I arrive at the hospital?
Upon admission, you will be required to pay the difference,
if any, between your verified insurance benefits and
the estimated charges for your stay. This amount is
based on the average of actual daily hospital charges
for patients admitted with similar diagnoses, multiplied
by the number of days you are expected to be in the
hospital. Your actual charges may be more or less than
the estimate. If they are less, you will receive a refund.
The deposit does not include your physician's charges
or those of other consulting physicians. Those costs
will be billed to you directly, once you have returned
home.
Does
Shands provide free care for patients without insurance?
Shands HealthCare is a state and federally funded hospital.
Shands Health Care does provide an assistance program
for those that qualify.
Our outpatient practices require some type of payment
at the time of the service. Most all departments will
work with patients to reach an agreement as to the amount
that is owed per each visit.
For specific information,
please contact a financial representative at 352.265.0355 or 1.800.342.5364 (Jacksonville patients, call 904.244.4015), or view financial assistance policies for each facility below:
Does
Shands HealthCare accept my insurance?
Insurance acceptance varies from physician to physician
in our outpatient practices. To find out if a specific
physician will accept your insurance, you may contact
the Shands HealthCare Consultation Center at (800) 749-7424
or locally at (352) 265-8000 and press 1 when prompted.
A service representative will be happy to assist you.
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Medicare
How much
will Medicare or Medicaid pay?
Medicare and Medicaid will pay for hospital services.
You will be responsible for the co-payment. If you belong
to a Medicaid Managed Care Plan or if you signed over
your Medicare benefits to a managed care plan, you may
need an authorization to see a UF physician or receive
hospital services. Visit our Insurance information online
to find out more specific information.
Why
do I have to give you information about other insurance
if I have Medicare coverage?
Medicare requires us to bill any insurance company that
could have responsibility for your expenses before we
bill Medicare. In fact, Medicare will not allow us to
file claims until the other insurer has denied claims.
In certain situations, the hospital must consider the
possibility that another party may be responsible for
your expenses before we bill Medicare. For example,
if you were injured in a car accident, at your work
site or on someone else's property, it is the hospital's
responsibility to make sure those claims are filed appropriately.
Consequently, we need to have complete information about
all insurance coverage you have.
Do
I have to sign any forms before Shands can bill Medicare?
You will be asked to sign a Consent for Treatment form
each time you receive services. You will also be asked
questions each time you receive services that Medicare
requires we ask.
You may contact GHI/COB Customer Service Center at (800)
999-1118 to update your common working files master
files.
I
have health insurance in addition to Medicare coverage.
Will you bill that insurance company also?
If you have given us information about your additional
health insurance, we will bill that insurance company
after Medicare makes their payment.
What
is the Medicare Explanation of Benefits form?
The Explanation of Benefits form is an information document
that Medicare sends to you after it has processed your
medical claims. The Explanation of Benefits form provides
you with information about the payment status of your
bill.
What
is the difference between Part A and Part B Explanation
of Benefits forms?
Part A covers inpatient hospitalization and Part B covers
outpatient and physician services.
What
should I do with the Explanation of Benefits forms?
We recommend you keep the Explanation of Benefits forms
you receive from Medicare until all your medical claims
have been paid in full. If you have other health insurance
in addition to Medicare coverage, your insurance company
will normally require a copy of the Explanation of Benefits
from you before they will pay any remaining balance
on your account.
Should
I pay the balance that is listed as "your total
responsibility" on the Explanation of Benefits
form?
No. This amount could change depending on your individual
insurance coverage. You should wait until you receive
a bill from your medical provider before making payment.
Will
I have to pay any money for my hospital visits?
As a Medicare patient, you will only be responsible
for non-covered charges, co-pays and deductible amounts.
These amounts may vary depending on your Medicare coverage.
We do not know what your payment may be until we receive
the notification from Medicare. Once Medicare lets us
know your responsibility, we will bill your other health
insurance company (if you have coverage) for the balance.
If you do not have other health insurance, you will
be billed for the balance.
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