Patient Financial Services
FAQ
We're here to help with your billing questions. It's important to us that you understand what the charges are and how to work together with us and your insurance company to ensure your care is the best it can be.
Q. What is an EOB?
A. It’s an Explanation of Benefits. It shows how your insurance company processed your claim. It contains information such as copays, deductibles, or noncovered services. EOBs should be kept for future reference.
Q. Which insurance plans are accepted by Hayes Green Beach?
A. Medicare, Medicaid, Blue Cross, Blue Care Network, PHP, SPHN, PPOM, Aetna, and various other insurances are accepted at HGB. We will bill any insurance, regardless of participation. However, if your insurance isn’t normally accepted at HGB, your copayments and deductibles may be larger than they would be at a participating facility. Note: There may be differences in insurance participation between your doctor and the hospital.
Q. Why didn’t my insurance pay?
A. Perhaps your medical situation didn’t meet your insurance company’s definition of “medical necessity.” Maybe the medical attention you received does not qualify as a benefit of your insurance plan. Often the insurance company will cite a “non-emergent condition” as a reason for not paying. Your EOB should provide more specific answers to this question.
Q. Why does it take so long to get a statement showing what I owe?
A. A statement is not generated until all of your insurance companies have responded or made payments. In extreme cases, it may take up to a year for their response.
Q. Why do I get questionnaires from my insurance companies?
A. Insurance companies may need to gather additional information from policyholders before processing payments. Therefore, these questionnaires should be filled out and returned promptly to your insurance company.
Q. If I owe the hospital money, what assistance is available?
A. HGB offers several payment options based on patient need. Please call for individual assistance.
Q. Why doesn’t Medicare pay for some drugs for my outpatient service?
A. This is a congressionally mandated law. (See your Medicare handbook for details.)
Q. When I am getting services at HGB, why am I getting bills from other providers?
A. In order to provide our patients with excellent healthcare, certain services (such as lab and x-ray procedures, for example) may require interpretations and/or assistance from outside providers.
Q. How do I know if my services require prior authorization?
A. Some procedures will not be paid by your insurance company if prior authorization was not obtained. Please refer to your insurance handbook to learn how your company handles this type of situation, or call the number listed on the back of your insurance card.