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What You Need to Know About Insurance and Billing

Hospital Bills and Insurance
All patients should familiarize themselves with the terms of their insurance coverage. This will help you to understand the hospital’s billing procedures and charges. Please remember that your policy is a contract between you and your insurance company and you may have the final responsibility for payment of your hospital bill from Catholic Health Services. We have several payment options available to assist you in paying your hospital bill.

The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. If we have a question about your insurance coverage, a member of the Patient Accounting Department may contact you or a member of your family while you are here. Information may be needed in order to process your claims.

Your Hospital Bill from Catholic Health Services
Your bill from Catholic Health Services reflects all of the services you receive during your stay. Charges fall into two categories: a basic daily rate, which includes your room, meals, nursing care, housekeeping, telephone and television; and charges for special services which include items your physician orders for you, such as X-rays or laboratory tests.

For questions regarding your hospital bill from Catholic Health Services, please call our patient account customer service line at 1-888-681-1752.

Bills for Other Services Received at the Hospital
If you have certain tests or treatments in the hospital, you may receive bills from physicians you did not see in person. These bills are for professional services rendered by these doctors in diagnosing and interpreting test results while you were a patient. Pathologists, radiologists, cardiologists, anesthesiologists and other specialists perform these services and are required to submit separate bills.

If you have questions about these bills, please call the number printed on the statement you receive from those specialists.

If You Have Health Insurance
We will need a copy of your identification card. We also may need the insurance forms, which are supplied by your employer or the insurance company. You will be asked to assign benefits from the insurance company directly to the hospital.

If You Are a Member of an HMO or PPO
Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your health care plan and their services may not be covered.

If You Are Covered by Medicare/Medicaid
We will need a copy of your Medicare card to verify eligibility and process your Medicare claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments also are the responsibility of the patient.  All Medicare patients will be provided with information, in writing, of their right to be notified in advance of discharge and their rights to appeal a discharge and the process for doing so.

We will need a copy of your Medicaid card.  Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless it is medically necessary.

If You Have No Insurance
A representative from the Admitting Department will discuss financial arrangements with you. This representative is also available to assist you in applying for Medicaid and can provide you with information for other government assistance programs.

Financial Assistance
We understand that reasons will exist which may result in your inability to pay for the medically necessary hospital services provided by St. Charles Hospital and its staff. If you are unable to pay for the medically necessary hospital services you require, please let us know in advance so that we are better able to assist you. Please be assured that you will not be denied the services you need based on your inability to pay. If this is the case, please assist us by calling our Financial Assistance/Medicaid Department representative at: (631) 474-6588.

For more information, please visit our page "Paying for Your Care"