Frequently Asked Questions
Columbus Community Hospital’s Patient Accounts Department offers a variety of services to help patients finance their medical care. They also answer patients’ medical billing questions. Some of the most common of these questions are addressed below:
If you have questions that have not been addressed here, please contact the Patient Accounts Department at 402-562-3159 or firstname.lastname@example.org
1. What is an “EOB” Explanation of Benefits?
A: A statement sent from a patient’s health insurance provider to the patient that lists services that were billed and how they were processed. The document lists deductibles, co-insurance, the amount insurance may have paid and the amount due by the patient.
2. What does Deductible, Co-insurance and Co-pay mean?
provisions that require the member (patient) to accumulate a specific amount of medical bills before benefits are provided by the insurance company.
after deductibles are met, the plan begins paying a percentage (usually between 80 to 100 percent) of covered charges. The remaining amount, called co-insurance, is paid by the member (patient).
a co-pay is usually a fixed fee ($10, $15, $50, etc.) the member (patient) pays to providers (doctors/hospitals) at the time covered services are performed. The level of co-pay is determined by the insurance benefit option.
3. What does “PPO” mean?
A: A Preferred Provider Organization (PPO) is made up of physicians, hospitals, health care providers and clinics that sign contracts with PPO systems to provide care to its insured people, agreeing to accept the PPO fee schedule and guidelines.
4. If CCH does not participate in my healthcare plan (non-network), am I responsible for the out-of-network charges?
A: Yes, it is your responsibility to make sure the requirements of your plan have been met. (For example, you may be required to have pre-certification of a procedure or visit.) Check your insurance policy booklet to ensure that CCH and your physician participate in your health care plan.
5. Can I set up a payment plan?
A: Yes, CCH follows payment guidelines that state: Either patients make the payment in full, or we offer monthly payment options when patients need more than 90 days to pay their accounts.
6. I gave you my insurance card before, why do you need it again?
A: We request that you bring your current insurance identification card each and every time you come to CCH. This will enable us to file your claim properly, as most plans have special requirements and insurances change.
7. What does “third-party liability” mean?
A: Examples of third-party liability are auto accidents, falling in a parking lot or any other incident where someone else may be liable for the patient’s medical charges.
8. What is SAM (self-administered medications)?
A: Medicare has a list of drugs they consider “self-administered” and these drugs are excluded from coverage in the Medicare program. A drug is considered self-administered when it is self-administered by more than 50 percent of Medicare beneficiaries on an outpatient basis. This determination is made on a drug by drug basis. When given in an outpatient setting, these drug costs are the responsibility of the patient.
9. What do you mean when you ask for the Guarantor number or the Account number?
A: CCH does “Guarantor” which is “family” billing. That means the “Guarantor” will receive “one” Guarantor number. This number is located in a box in the top right of a patient’s statement under the box that shows the patient’s name.
However, each time a patient or his or her family member is seen at CCH, a separate “account number” is assigned to each patient. These “account numbers” are located in the body (middle) of patients’ statements with the patient name, date of service and summary of charges. The statement is sent under the “Guarantor” name and this statement will include each separate current “account” number for each patient in the family who was seen.
10. Why didn’t insurance pay my bill?
A: CCH will file your claim with the information you give at the time of registration. It is very important that patients bring their new/current insurance card, Medicare card and Medicaid card at each and every visit to ensure accurate filing of their claims. If patients’ insurance companies have not paid for their medical services, patients will receive a statement for these services. If this happens, patients should contact CCH’s Patient Accounts Department. Insurance companies frequently request additional information from patients in order to process their claims. The Patient Accounts Department may ask patients to contact their insurance companies to resolve any delays in processing claims.
Please remember, as a courtesy, CCH’s Patient Accounts Department submits patients’ claims to their insurance companies. However, these professional services are rendered to patients and not the insurance companies; therefore, patients are directly responsible for the cost of their treatment.
Please remember, as a courtesy, we submit your claims to your insurance company for you. However, our professional services are rendered to you and not the insurance company; therefore, you are directly responsible for the cost of your treatment.
For additional information on CCH’s Patient Accounts Department, please visit the Patient Financial Information page
of our website, call at 402-562-3159 or email email@example.com
Patient Accounts Department
Columbus Community Hospital
4600 38th Street
Columbus, Nebraska 68602-1800