Peninsula Regional Medical Center - Part of Peninusula Regional Health System


Frequently Asked Questions


FREQUENTLY ASKED QUESTIONS

Why do I get more than one bill?

For some services, such as Emergency Department visits, operating room procedures, laboratory and radiology  (x-ray) testing, there are separate bills from Peninsula Regional Medical Center and the physician.  For instance, when you have an x-ray, Peninsula Regional will send you a bill for the "technical component" which covers the cost of registration, equipment, film and the technician who took your x-ray.  The physician who reads your x-ray will also send you a bill for the "professional component" which covers the time and expertise necessary to diagnose your injury or disease.
Typically, if you receive the Medical Center service on the left side in the chart below, you should expect a bill from Peninsula Regional and from a physician group listed on the right.

 

Hospital Service

Professional Service

Emergency Room

E.R. Physician

Operating Room

Surgeon, and possibly Anesthesiologist

Laboratory

Pathologist

Radiology, MRI, Ct Scan

Radiologist

Inpatient

Attending Physician, and Consulting Physicians


Will you bill my insurance company for me?

Yes.  As part of the service Peninsula Regional Medical Center provides, we will use the information you provide at the time of registration to bill your primary and secondary insurance companies.  If your insurance asks you for special forms such as accident information, a claim form or coordination of benefits questionnaire, it is your responsibility to provide this information.
Insurance coverage is a product you purchase directly or through a combination of payroll deduction and employer contribution.  If the insurance coverage you purchase fails to pay, you are responsible for the bill.
 
What do I have to pay at the time of service?

Any co-payments indicated on your insurance card will be collected at the time of registration.  All deductibles and estimated co-insurance are due at the time of registration.

If Peninsula Regional Medical Center is not able to determine your self-pay liability, a deposit equal to 1/3 of the estimated charges is due before services are rendered.

Should I tell my insurance company that I'm going to be in the Medical Center?
How much of the bill will my insurance company cover?

Notification requirements and coverage both vary with each plan offered by individual insurance companies.   It is always a good idea to check with your insurance company about your individual plan's notification requirements just to be sure.  In some cases, failure to notify your insurance company could result in you being responsible for the entire bill.

You may also want to consult the benefits book issued by your insurance company when your coverage became effective.  This book usually contains your responsibilities and detailed information about what is covered.

I already have a monthly payment arrangement with Peninsula Regional.  Why am I getting a separate statement for my most recent visit?

The monthly payment plan you have with our Medical Center is based upon the total amount outstanding at the time you established the monthly payment.  If you would like to add a new account to your existing monthly payment you must call Financial Services (410-543-7436) to discuss your account with a representative. 

Why do I get a questionnaire about my insurance every time I have a service? (Medicare patients)

It is a Medicare requirement that a provider ask the appropriate questions to determine whether or not Medicare is the primary payer for each bill it submits to the Medicare Program.   Peninsula Regional Medical Center makes every effort to ensure your account is submitted correctly to the proper insurance company.
 
How may I pay the balance I owe?

Peninsula Regional Medical Center accepts MasterCard, Visa, Discover and American Express.  You may enter your credit card information on your statement, we can accept your credit card payment over the telephone, or you can pay with your credit card through this web site.  Please select the "Bill Pay" option in the Quick Links section on the right side of this page.

You may pay by check.  Please make the check payable to Peninsula Regional Medical Center and write your account number on the check.

Credit cards, checks, and cash payments can be made at the Cashier's window located in the Frank B. Hanna Outpatient Center.

Monthly payments can be established based upon financial status and outstanding balance.   If the balance cannot be paid in full within 3 months, Peninsula Regional makes arrangements with another firm to bill and monitor extended payment plans.

Why do I get a statement when I don't owe any money?

Peninsula Regional Medical Center sends statements to patients while we are attempting to collect from your insurance company.  We do this for three reasons.

1. Many patients prefer to know what is going on with their account so there won't be any surprises at a later date.
2. It allows you to verify that the insurance information you provided at registration is what Peninsula Regional is actually billing.
3. When Peninsula Regional is experiencing difficulty in getting an insurance claim paid, a call to the insurance company from you (their customer) can cause them to take action.

Do I need to bring my insurance card with me to the Medical Center?

Yes.  Peninsula Regional Medical Center does keep your insurance information on file, but it is critical that we verify the accuracy of your insurance information each time you register.  Getting the insurance information correct allows us to expedite payment and minimizes your involvement in the resolution of your account.

When will I be responsible for the bill?

Your bill is due on the date of service but the complexity of insurance makes it difficult to determine exactly what your insurance company will pay.  Any amount we can determine with certainty, such as co-payments and deductibles, will be collected on the date of service.  As soon as your insurance company pays their portion, Peninsula Regional will send you a statement indicating what amount you owe after insurance.


My statement asks me to call my insurance company.  Doesn't Peninsula Regional Medical Center call my insurance company, too?

Yes, we work with several people in Claims Processing and Provider Relations at your insurance company.  But sometimes, despite our best efforts, we cannot convince your insurance company to pay the claim.  At this point we ask that you call your insurance company because you are their customer.  Peninsula Regional is just another provider asking for money and if we are at a point where their denial is final, you may be responsible for the bill.  In some cases, insurance companies are more willing to take action when a customer, rather than a provider, is the one making the request.  We are trying to exhaust all options before we make you the responsible party on the claim.

What is the difference between a co-pay and co-insurance?

A co-pay is a set amount the insurance company expects a patient to pay at the time of service.  The co-pay amount can change depending on the place of service, the type of plan, and whether you are in-network or out-of-network.  In many cases, your insurance card will indicate your co-pay amount.
 Co-insurance is the percentage of charges that the insurance expects a patient to pay.  For example, your insurance company may pay 75% and have a co-insurance of 25%.  Usually, you are billed for the co-insurance amount after your insurance company pays their portion.  In cases where Peninsula Regional Medical Center knows the exact amount of charges on the date of service, you may be asked to pay your co-insurance amount also.