Understanding Your Bill
When should I expect to receive a bill?
Generally, claims are submitted to the insurance carriers on a daily basis and processed by the insurance carrier within 30 to 60 days. After the insurance carrier processes the claim, a statement for any guarantor responsibility will then be billed to you. If your insurance carrier requires additional information or denies the initial claim, an appeal process may delay your billing an additional 2 to 4 months.
How can I receive a copy of my itemized charges?
At the patient/guarantor’s request, an itemized statement may be provided. Please call our Patient Accounts department at (337) 289-7287 to request the itemized statement.
Why are there names of physicians on my statement that I haven’t seen?
Certain physicians help with your medical care even though you may not meet them. Commonly, these are the doctors who read your lab results, x-rays and EKGs, among others.
What is the best way to pay my bill?
There are 3 ways to submit a payment on your account.
- Use our convenient online bill payment solution.
- You may call (337) 289-7287.
- If you would prefer to submit a payment by mail, please use the tear off section of your account statement to remit your personal check. A return envelope is enclosed for your convenience. Any payment information will appear on your next monthly statement.
What kind of charges/services are included on my hospital bill?
Your hospital bill reflects all the services you receive including charges for your room, equipment, supplies, diagnostic and therapeutic testing. It will NOT include any professional service charges rendered by your physician or by other health professionals. This may include Radiologists, Cardiologists, Emergency Room Physicians, Anesthesiologists or other specialists who diagnosis or interpret test results. These charges will be billed separately by those physicians or physician groups.
Who do I contact if I have a question about my bill?
There are a couple of ways to contact us if you have a question or problem with your hospital bill. You may utilize our online “Contact Us” form to submit your question or describe a hospital billing problem or you may contact Patient Accounts Customer Service at (337) 289-7287, Monday-Friday, 8:00 a.m. to 4:30 p.m.
Why am I being billed for “self-administered drugs?
These are pharmacy charges that are non-billable to Medicare for any outpatient services. These are usually tablets, ointments, lotions, anything you can take yourself. Please refer to Medicare’s website for further explanation. You can also submit these charge to your Part D plan to reimburse you.
Why did I get multiple bills for the same procedure?
You may receive a statement for physician services and hospital services depending on where the procedure was performed.
Why does a single visit to a provider based clinic result in two charges?
A single visit to a physician may result in two charges: one for the professional component and one for the technical or hospital component.
Role of Insurance
How do I know if Lafayette General Health contracts with my health plan
To receive full insurance benefits, some insurance companies require patients to receive services with “in-network” or “participating provider” hospitals and physicians. Some insurance requires that certain services be authorized or pre-certified before the patient receives them. Call your insurance company to check its requirements and to make sure Lafayette General Health facilities are in the network. We have a current list available for your review, but it is still your responsibility to verify.
What if my insurance company has no contractual agreement with Lafayette General Health?
If you are a customer of a private insurance company that does not have a contractual agreement with Lafayette General Health, you can still receive treatment. However, you will be financially responsible for the total charges and may be asked to make a deposit before receiving medical services at any of our facilities. It is your responsibility to know what your insurance will and will not cover.
Does Lafayette General Health send the necessary information and paperwork to insurance providers?
Lafayette General Health System tries to send all the necessary information to insurance companies; however, they sometimes need more information from you to process a claim. This may include information about Coordination of Benefits; Student Verification; Accident or Third Party Verification; Pre-existing Condition; or Primary Explanation of Benefits (if claim was submitted to a secondary insurance). You should receive an Explanation of Benefits from your insurance company asking for this information. Please respond to have the claim processed correctly. If the requested information is not submitted to your insurance company in a timely manner, you will be responsible for the outstanding charges and will receive a statement from Lafayette General Health.
What is a Deductible? Co-payment? Co-Insurance?
A deductible is the amount you pay each year before your plan begins paying benefits. This amount is usually a set dollar amount such as $250 or $500. Some policies may have much larger deductibles such as $5,000 or greater.
A co-payment is a cost sharing agreement in which you pay a flat-dollar fee for a specific service. An example would be where the insurance plan charges a flat $50 co-payment for all emergency room visits.
Co-insurance is the portion of your health care expenses that you are responsible for. If your co-insurance is 20%, then you would pay 20% of the expense after your deductible is met and your insurance company would pay the remaining 80%.
Who do I contact if I need to make changes or updates to my personal or insurance information?
Please contact the Patient Accounts Customer Service Department with any changes or corrections to your personal (i.e. address, phone number, name) or to your insurance information (primary or secondary). Please use the Contact Us form and follow the directions to submit your request. If you prefer to contact Patient Accounts Customer Service directly, call (337) 289-7287 between 8:00 a.m. and 4:30 p.m. regarding a hospital bill question.
Who is responsible for billing my insurance company?
Lafayette General Medical Center is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim once you have assigned benefits to us. You should remember that your policy is a contract between you and your insurance company, therefore, you have the final responsibility for payment of your bill.
What does “out of network” mean?
This typically means services were utilized by a provider that is not covered per your description of benefits. Please refer to your description of benefits provided by your insurance carrier.
Do I wait for insurance to pay all claims before I pay my out of pocket for each visit?
We try to determine your estimated out of pocket expense at the time of each service. We can only bill you for any deductible, co-insurance or co-pay as determined by your insurance carrier. Payment of any unpaid portions of out of pocket expense are due as insurance payment is made for each individual service to the hospital and no later than 30 days from their payment.
I have questions about Medicare. Do they have their own website?
Yes, Medicare has a comprehensive web site. Go to http://www.medicare.gov for more information on Medicare.
What does Medicare not pay for?
Medicare does not pay for any procedure it considers routine or preventive. You will be required to pay for these services.
What is an Advanced Beneficiary Notice (ABN)?
An Advanced Beneficiary Notice (ABN) is a written notice that you may receive from physicians, providers or suppliers, before they furnish a service or item to you, notifying you: (A) That Medicare will probably deny payment for that specific service or item in your case. (B) The reason the physician, provider or supplier expects Medicare to deny payment. © That you will be personally and fully responsible for payment if Medicare denies payment. An ABN also gives you the opportunity to refuse to receive the service or item.
I am an uninsured patient. What am I required to do?
Uninsured patients are required to deposit the estimated cost of scheduled services in advance. If additional testing, physician consultations or hospital admissions are necessary, additional deposits will be required. You can contact our Fee For Service line at 289-7283 to obtain a quote for services. Discounts for your services may be available.
Paying My Bill
Does Lafayette General Health offer payment plans?
Total payment is expected for the patient’s portion of the bill at the time of service or discharge. We accept cash, checks, money orders and all major credit cards. If you are unable to pay the full balance, you may qualify for a monthly payment plan based on an approved schedule. You may contact Customer Service at (337) 289-7287 and speak with a representative.
How will I know how much I owe?
If you have insurance coverage, your insurance company will send both Lafayette General Health and you an Explanation of Benefits (EOB) that details the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying. You may receive your EOB before Lafayette General Health does. Review your EOB carefully, compare it to your Lafayette General Health System statement and call your insurance company or our Customer Service department if you have any questions or concerns.
What types of payments does Lafayette General Health accept?
Lafayette General Health accepts cash, personal checks, debit cards, money orders, or credit cards (Visa, MasterCard, Discover and American Express). We will charge your credit card only for the amount you authorize.
How are my personal payments applied?
If payments are made online, your payment will be applied to the oldest balance first. If payments are mailed in, you can indicate the specific financial number to apply your payment on.
Will all of my balances show on the on line payment portal?
Only encounters where insurance has paid and you owe a balances will be reflected here.
If I have bills in Bad Debt, will they show on the online payment portal?
No, these bills will not be shown on the online portal, please contact the agency directly to make payment.
If I have a Delta Installment account, can I pay on this portal?
No, these bills will not be shown on the online portal, please contact Delta installments, call to make a payment over the phone or mail Your payment in.
Will old encounters with service dates prior to February 2012 be shown on the payment portal?
No, these will not be reflected here, please call us or mail payment to us on these encounters.