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A GUIDE TO UNDERSTANDING YOUR HOSPITAL BILL
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Not-for-Profit Care
Prince William Hospital is a not-for-profit community hospital. This means that
the money we receive for providing patient care is used to run the hospital and
to improve, update and expand services to meet the changing healthcare needs of
our community.
Prince William Hospital provides medical care without regard to a patient’s
financial status. As a not-for-profit hospital, our primary source of operating
money comes from the payment of patient accounts. Prompt reimbursement for
patient bills allows the hospital to continue providing a high standard of
care, while keeping down the cost of care for all patients.
We have trained Financial Counselors available to answer questions about your
bill as well as to help you set up a payment plan, locate financial assistance
if you do not have insurance, or assist you in applying for financial aid.
Your Hospital Bill –What Will You Have to Pay?
As the patient, you (or the person financially responsible for you) are
responsible for your bill, regardless of what insurance coverage you have. It
is important that you know the terms of your insurance policy – what it covers
and what you are required to pay.
Check pre-certification requirement. Many healthcare insurers require
pre-certification/authorization before or within twenty-four (24) hours after
hospitalization and will reduce or deny payments if this policy is not followed. You or your family must call your insurance company to ensure pre-certification is obtained.
Make payment arrangements early. If you are advised of charges that will
not be covered by your insurance, or if you believe you will have difficulty
paying the bill, it is important that you contact a Financial Counselor as soon
as possible at (703) 369-8020. Delays may cause problems in obtaining public
financial assistance or may lead to collection action.
Prince William Hospital’s Business Office will assist you with filing insurance
claims to help expedite payment of your account. We allow 60 days from the date
we bill your insurance company for payment.
If you have not received notice of payment from your insurance company within
30 days after hospital discharge, we encourage you (the patient) to contact
your insurance company directly and request prompt payment to the hospital.
Your Bill Will Include:
| | Fees for diagnostic laboratory and radiology tests, special treatments, supplies, equipment, operating and recovery room care, dietary upplements and medicines. |
Your Hospital Bill May Not Include:
| | Fees from your attending doctor(s). | | | Medical consultants’ fees. | | | The services of contract physicians, including specialists in radiology (X-ray), anesthesiology, psychiatry (behavioral medicine) and pathology (lab). |
These physicians work independently of the hospital and will bill you
individually for their specialized services.
Expenses Not Covered By Insurance
Deductibles, co-insurance and other charges not covered by your insurance will
be requested at the time you are registered, or a deposit on such charges may
be requested prior to your discharge from the hospital. (If you provide
accurate secondary insurance information, you will not be requested to pay
these charges.) If you are unable to pay such charges at the time, payment
arrangement must be made through one of our Financial Counselors. The hospital
will accept cash, personal or traveler’s checks and most major credit cards.
Our Financial Counselors will be happy to answer any questions you may have
concerning payment.
If you request a private room and there is no documented
medical need, most insurance carriers will not cover this charge. You will be
required to make a deposit for the difference between the private and
semi-private rates for three (3) days in advance or at time of discharge.
Unpaid Bills
Payment for services rendered is the primary source of operating income,
therefore, hospitals cannot afford to extend unlimited credit and must require
timely payment of bills.
Unfortunately, we have to take collection action on unpaid accounts. Following
the recommendations in this brochure will alleviate the need for such action.
We appreciate your complying with the following payment guidelines regarding
your specific insurance coverage. Your support in ensuring reimbursement for
medical bills will enable us to continue meeting the healthcare needs of our
community.
Self-Pay Patients
You will be classified as “Self-Pay” if:
| | At the time you are registered, you indicate that you will be responsible for all charges. | | | Your insurance company has paid its portion of the bill, and the remaining balance is your responsibility. | | | You do not have your insurance identification card with you, or you cannot provide accurate insurance information at the time that you are registered. | | | Your insurance does not authorize services rendered. | | | You are receiving services not covered by your insurance (i.e: cosmetic surgery.) |
Inpatient Services
For elective, non-emergency procedures, a $1,000 deposit will be requested when
you register.
Outpatient Services
Payment in full will be requested when services are rendered.
Emergency Care
An $85 deposit will be requested at the time of discharge.
Outpatient Surgery
A minimum deposit of $1,000 will be required at the time of registration with
an acceptable payment arrangement.
Physical Therapy / Rehabilitation Services
A deposit of $100 will be requested at the time of registration.
Payment will be accepted in the form of cash, check or major credit card. If
you are unable to pay, contact our financial counselors to make acceptable
payment arrangements. Elective, non-emergency procedures may need to be
rescheduled, if financial arrangements cannot be made.
BLUE CROSS PLANS / COMMERCIAL & INDEMNITY
Individual insurance plans may differ with regard to the benefits and
coverage they provide. Please present your insurance identification card when
you register.
Inpatient Services
Payment of policy deductibles, co-payments or any additional non-covered
charges will be required at admission. Emergency/urgent admissions will require
a deposit prior to discharge.
Outpatient Services (includes same-day surgery)
When you register, a deposit will be requested for policy deductibles or
co-payments.
Emergency Services
To cover deductibles and co-insurance, a deposit will be requested at the time
of discharge.
MANAGED CARE / HMO / PPO PLANS
Individual insurance companies provide different coverage and benefits. Please
present your identification card when you register.
Referral Inpatient Services
Payment of policy deductibles or co-payments will be requested at the time
of registration. Emergency/urgent admissions require a deposit on non-covered
charges, deductibles or co-insurance prior to discharge.
Outpatient Services (includes same-day surgery)
When you register, a deposit will be requested for policy deductible or
co-payments.
Emergency Services
To cover deductibles and co-insurance, a deposit will be requested at the time
of discharge.
MEDICARE
Inpatient Services
If you have not been admitted to the hospital in the past 60 days, the current
year’s deductible will be requested at the time of admission if no secondary
insurance is in effect.
Emergency Services
To cover deductibles and co-insurance, a deposit will be requested at the
time of discharge.
Medicaid
Please present your Medicaid card when you register. Otherwise, you will be
registered as a “Self-Pay” patient until you furnish the appropriate
information.
Automobile Accident Billing
The hospital wants to ensure that you receive the best possible care for
emergency services. In the event of an automobile accident, we will send the
bill for medical services to the patient or guarantor. We request that you
provide all necessary information to the appropriate automobile carrier for
payment. While you await reimbursement, the hospital requests that you speak
with one of our Financial Counselors at (703) 369-8020 to make suitable payment
arrangements.
Worker’s Compensation
In the event of a work-related accident, the hospital will submit your bill
for confirmed and authorized worker's compensation injuries to the appropriate
worker’s compensation carrier. If your injury is not confirmed and authorized
by worker’s compensation, the hospital will accept information and bill your
commercial carrier approximately three to five days after your visit.
For All Types of Insurance
If you have questions regarding insurance billing, please contact our
Business Office:
Monday through Friday
8:00 a.m. to 5:00 p.m.
(703) 369-8300
If your question relates to insurance coverage or benefits, contact your
personnel office or your insurance company’s customer service number.
If you have no insurance (classified as “Self-Pay”) and need assistance
regarding your bill, please call:
Financial Counselors
Monday through Friday
8:00 a.m. to 5:00 p.m.
(703) 369-8020
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