I am having some therapy services for an extended period of time. How does the billing process work in this circumstance?
The accounts are billed in 30-day or monthly intervals depending on health plan requirements. Therapy accounts are valid for up to six months. If treatment goes beyond that you will be asked to re-register under a new account number. Please contact us at 330-344-2000 or 1-866-440-0257 if you have any questions on your therapy account.
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I am a new patient at Akron General. Please briefly explain the billing process.
Before services are provided, you will be asked to register. This may be over the phone, or in person at the facility. You will be asked to provide a copy of your health insurance card(s). Providing your card(s) is very important, and will help ensure a smooth billing process. After we obtain your health plan information, we will print a registration record listing the information you have provided. Please review it carefully to be sure we have all information correct. Your signature attests to its accuracy and gives us permission to bill the health plan(s) listed.
We will provide you with an estimate of your out-of-pocket responsibility when possible. Discounts are available when these amounts are paid at the point of service.
We will bill your primary health plan and all additional health plans. After they have paid, we will bill you for any patient amounts owed by you, which could include your deductible, co-pay or co-insurance that remain.
Medical billing is a complicated process, and it may be several months before you receive a statement showing your personal responsibility. Our statement includes a summary of charges, and a list of any adjustments or payments made. The balance should be paid by the due date shown.
You will receive separate bills from your doctors (professional bills) and the Medical Center (hospital bill). For example, if you have a procedure done at Akron General that requires services from a radiologist, a surgeon, a pathologist and an anesthesiologist, you will receive a separate bill from each professional in addition to your bill from Akron General.
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I have concerns about the care I received and would like to talk to someone about it before I pay my bill in full. How will this be resolved?
Fortunately, it is rare that our patients feel this way. However, Akron General does have a Patient Advocate on staff to assist patients that may have a concern about the care received. Please call 330-344-6711 to speak to our Patient Advocate. It is also very important to keep in mind that the balance owed is your responsibility until your concerns are resolved. To avoid collection activities, it is important to pay the bill in full, or set up an acceptable monthly payment plan. Any amounts paid that are subsequently determined not due from you will be promptly refunded.
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Why did my insurance company deny paying my hospital bill?
Unfortunately, there are many reasons why health plans deny paying bills or pay only a portion of your bill. They may not have been able to properly identify you as a plan member. They may think another payor is responsible for payment. They may think that the service was not covered, or that the service was experimental. Perhaps they applied the charges to deductible or coinsurance amounts. Were you out of network, or did you receive a service without the required pre-authorization?
It is important that you know why your bill was not paid. Many times the explanation is on the health plan Explanation of Benefits (EOB). If not, or if you still have questions, we encourage you to contact your health plan directly.
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How can I get a detailed bill that shows all of the items billed to me?
You can use our Automated Account Information System 330-344-1135 or 1-866-246-3472 anytime to request one or simply call us during business hours at 330-344-2000 or 1-866-440-0257. Whether you're using the Automated Account Information System (AAIS) or speaking with a billing representative, you will need your account number from your statement handy.
If you are enrolled in Medicaid, itemized statements are not available through Automated Account Information System (AAIS). Please contact us during business hours at 330-344-2000 or 1-866-440-0257.
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I am having a baby. What do I need to do to be sure my baby's account is covered?
Congratulations! Please make sure you call your employer's benefits department as soon as possible to have your newest family member added to your health plan. In most cases, we can give you an estimate of the total out-of-pocket expense you can expect for the delivery of your baby. We can set up monthly payment plans that you can pay throughout your pregnancy, or you can pay the estimate amount in full to receive a Prompt Pay Discount. Either choice will help relieve you of the financial stress when you take your newborn baby home.
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How does your contractual agreement with my health plan company affect the billing process?
We will post the appropriate adjustment based on our contractual agreement. If the amount we bill you does not match the amount shown on the Explanation of Benefits (EOB) from your health insurance company, please call us at the number on your bill. We will work with you and your health plan company to resolve the difference. In some cases, companies take discounts for which there is no contractual agreement. In these cases, we must look to you for payment or resolution with your health plan.
How long will it take my health plan to pay their portion of the bill?
On average, a health plan will process a claim within 45 days of receiving the bill. We will follow up with the health plan to expedite the resolution of the claim. At times, you may need to contact the health plan company to assist in this process.
Why did my health plan pay only a part of my bill?
Most health plans require that you pay a co-payment, coinsurance and/or a deductible for your healthcare expenses. Your bill may include charges that you are responsible to pay, such as non-covered items or out-of-pocket expenses. Contact your health plan for specific information pertaining to your coverage.
Why do I need to call my health plan if they do not pay the bill?
We will make every effort to obtain payment on the account from your health plan, but we may need your assistance to resolve any concerns. By contacting your health plan and encouraging them to pay will help you avoid receiving a bill for services that should be paid by the health plan.
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Does Medicare cover everything?
There are some items that are excluded from Medicare coverage such as drugs that can be self-administered in an outpatient setting. These include most oral drugs given in the Emergency Department, treatment areas or observation rooms that are not a part of treating the issue you are being seen for.
Some screening tests and pre-surgical testing charges may not be covered. If you have questions, please discuss them with your doctor's office or with us prior to receiving the tests.
Your Medicare handbook is a good reference for this information. You can obtain one by calling 1-800-MEDICARE (800-633-4227). You can also order, view or download the Medicare & You handbook by visiting www.medicare.gov. Select "Publications."
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How do I pay?
You can pay by mailing in your check, money order or credit card information with the remit stub from your statement, or call us during business hours to make a credit card or check by phone payment. We accept Visa, MasterCard, Discover and American Express.
If you have a payment plan and are getting a past due notice, you may have paid less than the agreed upon amount or paid after the due date you selected. Try to catch up on your payments, if possible. If that's not possible, please call us at 330-344-2000 or 1-866-440-0257 to review your payment agreement terms.