LGMC has signed agreements with approximately 30 managed care organizations, including Aetna, Blue Cross/Blue Shield, Humana Office of Group Benefits and United Healthcare. LGMC also has approximately eleven group contracts with certain employers, enabling their staff to access hospital services at a discounted rate. In addition, LGMC is an equity member of the Acadian Health Care Alliance, a regional physician-hospital organization. LGMC is the sole provider of tertiary services among Acadian Health Care Alliance (the “Alliance”) member hospitals. Numerous agreements have been negotiated on behalf of LGMC by the Alliance, including agreements with CIGNA, Private Health Care Systems, Gilsbar 360 and several Medicare Select payers.
LGMC also has contracts with several Medicare Advantage (private fee for service) plans, underwritten by Aetna Health Management, Coventry Health Care, Humana Health Benefit Plan, Pyramid Life Insurance Company, United Healthcare Insurance Company, American Progressive Life & Health Company, Marquette National Life Insurance Company and WellCare of Louisiana. In 2012, LGMC contracted with 3 Medicaid Coordinated Care Networks: Amerigroup, LaCare, and Louisiana Healthcare Connections. LGH is a Preferred Provider for the following Affordable Care Act (Exchange) Plans: Blue Cross Blue Shield, Louisiana Health Cooperative and Vantage Health Plan.
Estimates & Insurance Process
You may request an estimate from the Patient Financial Services department which is located at 121 Audubon Blvd, Lafayette, LA 70503.
What is usually included in a service estimate?
Estimates are based on specific procedure, type of visit, length of stay and include only hospital charges. These charges may vary by a patients individual needs and by the physician ordering the service. Price estimates do NOT include charges for physicians or any professional services such as anesthesia, radiology, cardiology, pathology. These services are billed separately by the individual provider.
I have more questions about surgical estimates. Who can I call?
All pricing inquiries for Lafayette General Medical Center, Lafayette General Surgical Hospital, St Martin Hospital, University Hospital and Clinics, and Oil Center Surgical Plaza can call the CBO Pricing department at 289-7283 for assistance. Pricing inquiries for Acadia General Hospital are handled by calling 788-6405.
Patients with Insurance
Lafayette General Health will file primary insurance claims in all cases for patients with insurance, meaning:
- Lafayette General Health sends the claim directly to your insurance company.
- Each insurance company has its own benefits plan and requirements.
- It is vital for you to understand exactly what your health-care insurance policies provide, including whether the company has a contract with Lafayette General Health.
- You can obtain an estimate for a specific service. It is your responsibility to consult with your primary insurance company to determine whether Lafayette General Health’s bill will be covered in whole or in part, or what portion of the bill will be your personal financial responsibility. You may contact our Patient Financial Service Department for information on service estimates at 289-7283.
Patients with Secondary or Supplemental Insurance
- You must provide the Registration Desk with copies of both sides of your secondary insurance cards.
- Lafayette General Health will send a claim form to your secondary or supplemental insurance company.
Contracted Fee Schedule
If Lafayette General Health has a contract with the primary insurance company, Lafayette General Health agrees to accept the contracted fee schedule. Under this agreement, your out-of-pocket costs normally will be less. You will be responsible for any co-payments, coinsurance and deductible amounts as determined by your insurance company. The insurance company pays its portion of the total amount to Lafayette General Health.
Insurance Payments Sent Directly to Patients
Insurance payments sent directly to you, whether from primary or secondary insurance companies, should be used to pay outstanding charges to Lafayette General Health. Patients are financially responsible for all outstanding charges.