While hospital billing can be confusing, we hope the following information can provide answers to questions that you may have regarding the financial aspects of your visit. Professionally trained financial counselors are also available to assist you with financial needs and concerns. Please do not hesitate to ask them for assistance.
Patient Financial Guidelines: What You Need To Know About Paying For Your Health Services
Health Insurance Billing Process
As a courtesy to our patients, Albemarle Hospital will file a health claim to most insurance companies when you provide all of the required information. You will need to present your insurance card(s) at the time of service for correct identification of your insurance carrier and receiving the proper payment for services.
Commercial/Managed Care Insurance
Patients with commercial or managed care insurance coverage are responsible for paying co-pays, deductibles, co-insurance, and fees for non-covered services. Full payment of the patient’s responsibility is expected before services are rendered.
Insurance plans can differ significantly. Each patient has a responsibility to know and understand his or her individual benefit package.
If services you request are the result of a work-related injury, Albemarle Hospital will bill your employer or your employer worker’s compensation carrier. We will also ask for your health insurance information, should the worker’s compensation deny the claim or not cover all of the charges.
If services you request are the result of a non-work-related injury (i.e. an accident), Albemarle Hospital is required to file your liability if you are covered by Medicare and/or Medicaid. We will bill your commercial/managed care insurance company.
Patients that choose not to file their commercial/managed care insurance or patients with no other insurance coverage will be responsible for the bill at the time services are rendered.
“Medical Necessity” is a term that has been used in recent years by Medicare and may not be familiar to you. “Medical Necessity” means that there are procedures and services that physicians may prescribe what they may feel are needed to manage your health. However, Medicare may not pay for certain services based on their policies.
If your physician orders procedures or services that Medicare will not cover, you will be asked to sign an Advance Beneficiary Notice (ABN). The ABN informs you in advance that Medicare is not likely to pay for the procedure or service. By signing the ABN, you are indication that you understand and agree to be personally and fully responsible for payment. Payments of co-pays, deductibles, and fees for non-covered services are expected at the time services are rendered.
Albemarle Hospital will submit claims to Medicaid if you supply the required information, and/or verification of coverage is obtained through the Department of Social Services. You may be responsible for a portion of your charges if Medicaid does not cover the full amount.
If you feel you may qualify for assistance from the Department of Social Services, you may contact their office at (252) 338-2126.
Services Not Billed By Albemarle Hospital
During your hospital stay, you may receive treatment from physicians who bill separately for their services. Albemarle Hospital may provide your insurance information to these providers. If you have any questions about their bills, please contact them directly.
Some of these providers may include:
- Your physician, surgeon or consultant
- Emergency physicians who provide emergency room care:
Waterway Emergency Physicians (1-800-355-2470)
- Radiologists: Physicians who read and review diagnostic images (i.e. X-rays, MRI scans, etc.):
Eastern Radiologists, Inc. (252-752-5000, Press 2)
- Anesthesiologists: Physicians who administer anesthesia during certain procedures:
Albemarle Hospital Anesthesia (1-800-339-5844)
- Pathologists: Physicians who review tissue and lab specimens
Patient Financial Responsibilities
Patients who do not carry insurance coverage, who are unable to provide Albemarle Hospital with adequate filing information, or who wish to file their own insurance claims must either pay Albemarle Hospital in full at the time of service or make satisfactory arrangements for payment.
Patients with health insurance coverage will be expected to pay any co-pays, deductibles, co-insurance, or any other patient portion at the time services are rendered. Any additional or remaining balance will be billed to you and are due upon receipt of the statement.
If your account becomes past due, Albemarle Hospital will take appropriate action to recover the amount. Accounts are considered past due if your payment has not been received within 25 days of the date of statement. If you are unable to pay your balance by the due date, it is your responsibility to contact the Billing Office to discuss a workable solution.
Delayed insurance payments do not relieve you of your obligation to pay balances when due; the responsibility still rests with you.
We realize that unanticipated service needs at Albemarle Hospital may result in unexpected expenses for you. Therefore, we want to give you many payment options:
- Check/Money Order
- Debit Cards
- Credit Cards: Visa, MasterCard, and Discover
Albemarle Hospital has other options we can discuss with you, such as Government Assisted Programs and our Charity Care Program. Assistance is based on financial need, and required documentation is necessary to qualify.
If you have any questions, please do not hesitate to ask for assistance from one of our professionally trained financial counselors.
Contacts and Phone Numbers
Below are contacts and phone numbers that may be helpful prior, during, and after your service is rendered:
Billing Office (252) 384-4627
Assistance is available Monday through Friday from 8:30 a.m. to 5:00 p.m. for any questions or concerns you have about your patient bill after services have been rendered.
Preregistration (252) 384-4089
You may preregister for future hospital stays Monday through Friday from 9:00 a.m. to 9:00 p.m. Please have your physician order and insurance information in front of you when you call.
Patient Financial Assistance (Billing Department)
Click here for more information.