Understanding My Bill

You will receive bills for professional (physician) and hospital (laboratory, X-ray, medication, etc.) services. Insurance companies require that these services are billed on different forms.

The purple statement (physician bill) includes fees for examinations, consultations, and readings and interpretations of outpatient tests, such as laboratory, X-rays and CT scans. 

The blue or green statement (hospital bill) includes fees for room and board, use of equipment, nursing care, outpatient facility exam room, and medications. You will receive this for each date of service – except if your child is having therapy services and is categorized as a “recurring patient.”  In that case, you will have one account that spans an entire month. Because our computer systems track these charges separately, you may receive more than one bill for one hospital or clinic visit.

For example, you may receive a doctor’s bill after visiting the emergency room, and a bill from the radiologist who read your child’s X-ray and a bill from the hospital for related charges. We also bill a facility charge for outpatient hospital-based clinic visits. This is separate from the cost of the medical provider and includes the cost to run the facility such as supplies, equipment, exam rooms, educational resources, counseling, and other staff. Charges are based on the type of visit and hospital resources it takes for your child’s care. The exact charge cannot be calculated until after the medical services have been provided and their visit is finished.

Medicaid covers the full outpatient facility charge, so you will not have a balance to pay for the charge. If you have Children’s National's Financial Assistance, this program covers the charge based on a sliding scale up to 100 percent. If you have commercial insurance, the portion of you what you will be responsible for depends upon your plan’s benefits and deductible amounts.

If you feel like a discrepancy has occurred on any of our bills, please contact customer service as soon as possible to prevent a delay in processing your claims.