Key Information for Your Child's Stay
understanding your bill
Take Charge of Your Payments
The hospital billing process may seem complicated, but you can feel more in control by knowing exactly what your bill covers. For example, if your child stays overnight, you can expect to see charges for the room, meals, 24-hour nursing care and medicines. The bill will also show charges for any special services, such as X-rays and lab tests. You’ll receive bills for doctors, surgeons and specialists separately from the hospital.
Commercial Insurance Providers
If you use a commercial insurance provider, then the hospital forwards your claim to your insurance provider based on the information you provide at registration. About a month after your child leaves the hospital, you’ll get an explanation of benefits (EOB) statement from your insurance provider. This isn’t a bill. EOBs show:
- the amount billed by the doctor or hospital
- how much of that cost is covered by your insurance
- how much you owe
Review this and all other bill-related documents carefully. If you have questions, contact your child’s doctor or the customer service number listed on the statement.
Medicaid and CHIP
Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health insurance based on your household’s income. If you earn too much to qualify for Medicaid, you still may be able to qualify for CHIP. You can apply for Medicaid or CHIP at any time, and if you qualify, coverage starts immediately. Visit healthcare.gov/medicaid-chip for more information.
Self-Pay Patients and Payment Arrangements
If you’re planning to pay your bills without help from a commercial insurance provider, then you’ll get bills directly from the hospital. Self-pay patients have the right to receive a “good faith” estimate before a planned hospital stay. To learn more, visit cms.gov/nosurprises.
When the first bill arrives, call the hospital’s financial services department to set up a payment plan. Communicate with the financial services department as soon as possible. If you don’t set up a payment plan, or if you stop making payments, then your account may be placed with a collection agency. The hospital wants to work with you, so reach out with any questions or concerns you have.
Commonly Confused Terms
- Deductible:
The amount you owe each year before your insurance begins making payments.
- Co-payment:
A flat fee you pay for a specific service, usually due at the time of service.
- Coinsurance:
The portion of your medical expenses that you’re personally responsible for paying. For example, your insurance may cover 80% of a bill, while you have to pay the remaining 20%.
Keeping Track
One of the key ways to feel well-informed and less overwhelmed about the hospital billing process is to stay organized. Keep all of your statements and bills together and review each one as it arrives.
Need Help?
If you don’t understand something on your bill, or if you’re having trouble paying your bills, contact Financial Services Assistance at 1-800-995-5727. Financial and insurance specialists are also available to help with information about Medicaid availability.
Understanding Coordination of Benefits (COB)
COBs happen when your child is covered under two or more insurance companies. This may occur when both parents carry their children on their individual policies.
To prevent duplicate payments, COBs determine the primary payer. Your insurance providers follow guidelines to choose who pays first. Check with your insurance provider about their rules for COBs, primary payers and forms to fill out.