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Insurance and Billing FAQs

As you navigate the process to pay your bill, the following frequently asked questions may be helpful to review.

Health insurance terms

  • What is authorization/preauthorization?
  • What is a benefit package?
  • What are carve outs?
  • What is co-insurance?
  • What is a co-payment?
  • What is a deductible?
  • What are definitions, benefits, limitations and exclusions?
  • What is an HMO?
  • Point-of-Service Plan or Point-of-Service Option (POS)
  • What is a PPO?
  • What is PSV?

Questions to ask the hospital

  • Why was my account placed with a collection agency before the hospital sent me a bill?
  • Why was my bill sent to the wrong insurance?
  • What if I cannot pay my bill in full at the time of service?
  • How can I obtain an estimate of costs for my child's care?
  • If I have a question about my bill, who can I contact?
  • Why are my out-of-pocket expenses based on my outpatient benefits?
  • What is the facility charge for outpatient visits?
  • Why do I receive a statement before the insurance has paid its portion?
  • Why do I receive two bills for each date of service?
  • What date of service does this bill cover?

Questions to ask your insurance provider

  • What types of services are generally covered by a group health insurance plan?
  • What if your child has a pre-existing condition?
  • Does my surgery/hospital stay need preauthorization?
  • Does the insurance company require a second opinion?
  • What else does the insurance company require?

What to know before you visit the hospital

  • What insurance information should I have on hand when I visit the hospital?
  • What if my child isn’t covered by insurance?
  • What do patients and parents/guardians have the responsibility to do?
  • What rights do I have if I am an adult patient?
  • What if I am the parent of an adult patient?
  • Who may sign paperwork and consent to evaluation and treatment for a child?