Frequently Asked Billing Questions | Pricing, Insurance & Billing | University Hospitals | Cleveland, OH (2024)

What is a deductible? A 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. 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 healthcare 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%.

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 healthcare expenses that you are responsible for. If your co-insurance is 20%, then you would pay 20% of the expense after your deductible.

What payment types are accepted for on-site payments, such as insurance co-payments?

University Hospitals doctors offices and facilities are no longer accepting cash or check as in-person payment for services, including insurance co-payments. You can pay by card (credit, debit, HSA, FSA, etc.) at the time of service. Apple Pay and Google Pay are available at select locations, and will be available to all locations beginning October 2023. Additionally, for many primary care offices, you can use UH MyChart to pay your bill online or before your appointment during eCheck-in. You will continue to be able to pay by check upon receipt of your patient statement after service is complete.

What is the "Free Care Program" (HCAP - Healthcare Assurance Program)?

This program provides, without charge, certain basic medically necessary hospital services if you are a resident of the State of Ohio and are not enrolled in the Medicaid Program and your personal or family income is at or below the Federal Poverty Guidelines. Please refer to the HCAP linkunder Request Forms or call 1-866-771-7266 for additional information.

What kind of charges/services are included in 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.

What kind of charges/services are included on my physician bill?

Your physician bill reflects the services that are personally performed by physicians and other healthcare professionals such as advanced practice nurses, certified nurse midwives, physician assistants, clinical psychologist and others. These include the services for visits, procedures, surgeries and anesthesia as well as the interpretation of diagnostic testing such as those tests performed in radiology and specimens sent to pathology. It is very likely that a patient will receive a physician bill from a provider whose name they do not recognize due to all of the behind the scenes activity that occurs in providing quality healthcare.

Who do I contact if I have a question or a problem with my hospital 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 free-form text, “Contact Us”, to submit your question or describe a hospital billing problem or you may contact Customer Service at 216-844-8299 or toll free at 1-800-859-5906, Monday – Friday, 8 a.m. to 5:30 p.m.

Who do I contact if I have a question or problem with my physician bill?

There are a couple of ways to contact us if you have a question or problem with your physician bill. You may utilize our online free-form text, “Contact Us”, to submit your question or describe a billing problem or you may contact Customer Service at 216-383-0100 or toll free at 1-800-589-6006, Monday – Friday, 8 a.m. to 5:30 p.m.

Who do I contact if I need to make changes or updates to my personal or insurance information?

Under “Common Request”, you can submit directly to the Customer Service Department any changes or corrections to your personal (i.e. address, phone number, name) or to your insurance information (primary or secondary). Please click on the appropriate link and follow the directions to submit your request.

If you prefer to contact Customer Service directly, call 216-844-8299 or 1-800-859-5906 between 9 a.m. – 4 p.m. regarding a hospital bill or 216-383-0100 or 1-800-589-6006 between 8 – 5:30 p.m. regarding your physician bill from University Hospitals.

Who is responsible for billing my insurance company?

University Hospitals is responsible for for submitting bills to your insurance company and will do everything possible to expedite your claim. 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.

Why am I being billed for "self-administered" drugs?

These are pharmacy charges that are non-billable to Medicare. Please refer to Medicare’s website for further explanation.

What does "out of network" mean?

This typically means services were utilized by a provider that is not covered at the highest level or reimbursem*nt per your description of benefits. Please refer to your description of benefits provided by your insurance carrier.

When should my Medicare be billed secondary?
Please refer to Medicare’s website for scenarios that fall into the guidelines for billing Medicare as secondary payer. www.medicare.gov/coverage or call 1-800-MEDICARE
How will my payment be applied to my physician bill?

University Hospitals Medical Group posts patient payments based on “oldest” date(s) of service first. This is an automated process unless a special request is made to post the payment otherwise.

Who do I contact if I need to discuss a quality of care issue?

Please contact the hospital Ombudsman or Patient Advocate.

Who do I contact if I've been a victim of fraud regarding a hospital or physician bill?

Please contact the Customer Service information identified on the statement that you received.

What is the "Uninsured Charity Assistance Program"?

University Hospitals is committed to treating all patients with dignity and respect regardless of their financial status or ability to pay. In support of this commitment, UH has established an Uninsured Charity Assistance Program. Through the program, UH provides discounts on hospital bills for Ohio residents who meet certain criteria. The amount of the discount is based on the patient’s or family’s income and Federal Poverty Guidelines (FPG). Please click Federal Poverty Guidelines for more information and to see if you qualify.

Frequently Asked Billing Questions | Pricing, Insurance & Billing | University Hospitals | Cleveland, OH (2024)

FAQs

What is the difference between hospital billing and office billing? ›

Setting: The primary difference lies in the setting where the services are provided. Hospital billing is associated with services rendered within a hospital facility, while professional billing is associated with services provided by individual healthcare providers outside of the hospital setting.

What questions should I ask about medical bills? ›

Here's where to start and what to ask for. Can I see an itemized bill? “It's estimated that about 60 percent of medical bills that are issued have errors,” says Greene, of Resolve. Always ask to see an itemized bill to make sure you're being charged correctly.

What number is 888 347 3295? ›

CMG (Includes outpatient clinics and practices)

The Patient Grievance Process excludes Patient Account/Billing issues. These issues should be referred to CommonSpirit Patient Financial Services at 888-347-3295.

How do I contact the Cleveland Clinic for billing? ›

Billing representatives are available for live chat Monday – Friday from 8 a.m. - 4:30 p.m. You may also contact Customer Service at 216.445. 6249 or toll-free at 866.621. 6385.

What are three different types of billing systems in healthcare? ›

In the world of medical coding and billing, understanding different system architectures is crucial for ensuring smooth financial operations. With that said, there are three types of systems you might encounter: closed systems, open systems, and isolated systems. Let's break down the differences.

What are the three main problems with billing in a health office? ›

Common Challenges in Health Care Billing Compliance
  • Coding errors: inaccurate or inconsistent billing codes and out of date information.
  • Upcoding: when patients are billed for a more expensive service than what was actually provided.
  • Undercoding: when providers intentionally leave out codes for services provided.
Nov 20, 2023

What do you say to negotiate medical bills? ›

Offer to pay upfront.

If you can afford to pay a portion of the bill upfront, you can sometimes reduce medical bills by earning a discount. Many healthcare providers are more likely to offer a reduced rate if they know they will receive payment promptly.

Are medical bills covered under Hipaa? ›

Although many people know that HIPAA protections apply to medical records and details about health care services, they may not realize that HIPAA also applies to payment-related information. The short answer to the question, “Is billing information protected under HIPAA?” is yes, it is.

How do you negotiate a medical bill collection? ›

For medical debt, it is common to negotiate to a lower amount than you were originally billed. For medical debt, creditors will typically settle for roughly the amount insurance companies pay for the same services, which is usually much lower than the amount that would be billed to an uninsured person.

Whose phone number is 888 221 7070? ›

If you are in doubt that the caller or visitor represents Pacific Power, please call us at 1-888-221-7070 to confirm the person's identity and role with the company before proceeding with any transaction.

Why does 1111111 keep calling me? ›

Telemarketing and Robocalls

Robocalls and Automated Systems: Robocalls, generated by automated systems, may utilize various numbers, including 1111111111, as part of mass calling campaigns. These calls might be promoting products, services, or political messages.

What is the phone number 8888888888? ›

Welcome to Justdial, your 'one stop shop' where you are assisted with day-to-day and exclusive planning and purchasing activities. We take pride in our iconic customer support number, 8888888888 and the fact that we own a strong hold on local business information pan India.

Does Cleveland Clinic charge a facility fee? ›

The facility and/or treatment room charge is the result of Cleveland Clinic's physician offices and outpatient clinics being classified as hospital outpatient departments, also called provider-based facilities. Provider-based billing applies to all patients, regardless of the type of insurance you have.

Who qualifies for financial assistance for medical bills in Ohio? ›

Healthcare Financial Assistance provides assistance to individuals who are uninsured for emergent medical and medically necessary healthcare. Patients who wish to apply for this program must be an Ohio resident and have income at or below 250% of the established annual federal poverty guide.

What does CCF mean in Cleveland Clinic? ›

The CLEVELAND CLINIC FOUNDATION (incorporated February 5, 1921) is an independent, not-for-profit academic medical center engaged in patient care, research, and education.

Do you understand the difference from hospital billing reimbursem*nts to that of a physician's practice? ›

Another key difference between physician medical billing and hospital billing is the reimbursem*nt rates. As a general rule of thumb, a medical biller for physicians typically has higher reimbursem*nt rates than hospital billing reimbursem*nt rates.

What is a hospital billing system? ›

Hospital medical billing involves creating and submitting healthcare claims to insurance companies to receive payment for services rendered by providers. It also includes billing payers for the medical facilities, special medical equipment and supplies, and laboratory services provided.

What is the difference between a medical office and a hospital? ›

A clinic is smaller than a hospital where patients are less sick and do not stay overnight. You should schedule an appointment to visit your doctor at the clinic. Some reasons to go to a clinic or Doctor's office to see your Primary Care Provider/Doctor are: Routine medical appointments.

What is the difference between PB billing and HB billing? ›

There are two primary types of medical billing: hospital-based billing and professional billing. Hospital-based billing is used for services provided within a hospital setting, while professional billing is used for services provided by individual healthcare providers.

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