Learn about your insurance coverage
Check with your insurance company about your specific coverage. Because there are so many types of insurance plans, it is difficult for us to tell you specifically what your insurance plan will pay. Many plans have amounts you will have to pay out of pocket, such as deductible and co-insurance, and many have coverage limits.
A deductible is an annual dollar amount that you have to pay before the insurance makes any payment.
Co-insurance, sometimes referred to as co-pay, is a percentage of the bill that you are responsible to pay. Most insurance will not pay for 100 percent of your medical bill.
Understand your insurance company’s precertification requirements and other requirements
Many health insurance companies require prior approval or notification of your hospital stay or outpatient treatment. If your plan requires precertification and you do not receive prior approval, your insurance company may refuse to pay for any of the related services.
It is important for you to check with your insurance company to identify what requirements you need to meet. If you do not meet the requirements, the entire bill may become your responsibility.
If you have a managed care policy, ask about agreements between your insurance company and your doctor
Payment for services can depend upon the agreements between medical providers and the insurance company. This is important information to ask about prior to receiving medical care. Your insurance company or your doctor’s office can assist with this information. Since it varies by doctor, it is important to identify all factors that may be involved with your medical care.
Understand that, in most cases, you will receive bills from the hospital as well as physician bills
The charges for services that you receive at St. Francis, the St. Francis Cancer Treatment Center, and Grand Island Imaging Center are billed by the hospital and cover the procedure (for example, an X-ray) or the use of hospital facilities (for example, emergency room). You can also expect to be billed by the physician who performs the procedure or interprets the test results. For example, a radiologist who reads an X-ray would bill you for that service, even though you may not see them. They provided reports to your regular physician to use in determining the appropriate medical care. Other billings that you may receive would include your physician and any physician that assists your physician.