Frequently Asked Questions Regarding Billing: 

What if there is an error on my bill?

If you have a question about your bill, or believe that it is incorrect, call the business office at 618-662-1620. 

What is a co-payment?

A co-payment is a set fee the member pays to providers at the time services are provided.  Co-pays are applied to emergency room visits, hospital admissions, office visits, etc.  The cost is usually minimal.  The patient should be aware of the co-payment amounts prior to services being rendered. 

What is a deductible?

Deductibles are provisions that require the member to accumulate a specific amount of medical bills before benefits are provided.  For example, if a member's policy contains a $500 deductible, the member must accumulate and pay $500 out of pocket before the insurance carrier will pay benefits.  Once the patient has met their deductible, the carrier usually pays a percentage of the bill.  The patient is liable for the unpaid percentage.  Deductibles are yearly, usually starting in January. 

What is a co-insurance?

Co-insurance is a form of cost sharing.  After your deductible has been met, the plan will begin paying a percentage of your bills.  The remaining amount, known as the co-insurance is the portion due by the patient. 

What is CRNA and why am I being billed for it?

CRNA stands for certified registered nurse anesthetist.  Whenever anesthesia is administered, a CRNA must remain in the room with you at all times, until the procedure is complete to monitor your response to the anesthesia.  The anesthesiologist will be with you at the beginning and at the end of the procedure and periodically during your procedure as he or she may have multiple patients at that time.  The CRNA is contracted by the hospital; therefore, the hospital bills for those professional services. 

What is the difference between an HMO and PPO?

HMO stand for Health Maintenance Organization.  An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals.  PPO stands for Preferred Provider Organization.  As a rule, you must select a primary care physician (PCP) who is under contract with the PPO.  If you choose a doctor not under contract, you pay more.  Like an HMO, you usually pay a small amount known as a co-pay each time you visit your PCP or health-care facility.  Unlike an HMO, if you choose to see a doctor who is not contracted with the PPO, the plan might pay a percentage of the medical bills (out-of-network benefits).  However your cost will probably be higher than if you choose a caregiver that is in the plan's network. 

Why did my insurance only pay part of my bill?

Most insurance plans require you to pay a deductible and/or co-insurance.  In addition, you could be responsible for non covered services.  Please contact your insurance company for specific answers to your question.  You may have out-of-pocket expenses. 

Why do I get so many bills for my hospital visit?

Pathologists, radiologists and primary care physicians are independent providers.  They bill separately from the hospital. 

Why do I need to call the Insurance company if they do not pay the bill?

If you have a PPO policy, you are ultimately responsible for the total bill or any portion of the bill your insurance carrier does not pay.  The Central Billing Office will make every effort to resolve the account balance with your insurance carrier.  Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance. 

Will my insurance plan pay for my treatment?