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.

Peninsula Regional Medical Group (PRMG) physician charges are not included in the hospital bill and are billed separately, with the exception of self-pay balances. Self-pay balances for hospital services and PRMG services will appear on the same statement. Physician charges outside of the PRMG group are not included in the hospital bill and will be billed separately. Physician charges outside of PRMG are not covered by Peninsula Regional Medical Center’s financial assistance policy. A list of providers that deliver emergency and other medically necessary care at PRMC is provided on the website, indicating which providers are covered under PRMC’s financial assistance policy and which are not.

Will you bill my insurance company for me?

Yes. As part of the service Peninsula Regional Medical Center provides, we will use the information we obtain from you at the time of registration to bill your insurance. If your insurance company 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. If your insurance coverage that you have purchased or is employer provided fails to pay, you may be 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 you self-pay liability, a deposit equal to one third of the estimated charges is due before services are rendered.

Should I tell my insurance company that I will be going to the Medical Center?

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 your being responsible for the entire bill.

How much of the bill will my insurance cover?

You may want to consult the benefits book issued by your insurance company when your insurance became effective or call them for the most updated information as some changes may have occurred.

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, please call Financial Services at 1-877-729-7762 to discuss your account with our representative.

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

It is a Medicare requirement that a provider (PRMC) 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 payment over the phone, or you can pay with your credit card through our online bill pay. To pay for services before November 1, 2016, visit our PRMC website https://www.peninsula.org   or go directly to https://peninsula.patientcompass.com/ .  For services from November 1st and after, you can use MyPenCare site – Click here for information.

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

Additionally, you may also pay by credit card, check or cash by visiting our Cashier window located onsite in the Frank B. Hanna Outpatient Center. Monthly payment arrangements can be established based upon financial status and outstanding balance. Please call 1-877-729-7762 for more information.

Why do I receive a statement when I do not owe money?

Peninsula Regional Medical Center sends you an account summary at the same time we bill your insurance. This allows you to verify that the insurance information you provided at registration is who Peninsula Regional is actually billing.

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 any balance you may owe.

Do I need to contact my insurance company during the billing process? Doesn’t Peninsula Regional Medical Center also call my insurance company?

Yes, we work with several people in Claims Processing and Provider Relations at your insurance company.  Sometimes, despite our best efforts, we cannot convince your insurance company to pay your claim. At this point, we may ask that you call your insurance company because you are their customer. Peninsula Regional is one of many providers asking to be paid. If we get to the 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 like you is the one making the request. We want to be sure we attempt all options prior to making you the responsible party for 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 changed 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 company 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.

If I deliver my child at Peninsula Regional Medical Center, will my newborn be covered under my insurance?

It is important to check with your insurance company prior to your delivery regarding how to add your newborn child to your policy. Each insurance company has different requirements and it is better to prepare for this to assure your infant is covered.

What do I need to do if I need assistance with my bills or have no insurance?

If at any time you have questions about obtaining financial assistance, your hospital bill, your rights and obligations with regard to the bill or applying for Medical Assistance, please contact Peninsula Regional Medical Center’s Financial Services Department at 1-877-729-7762.

To find out if you are eligible for Medical Assistance or other public assistance, please apply at your local Department of Social Services (DSS).

Maryland Programs – http://dhr.maryland.gov/weathering-tough-times/medical-assistance/

If you are applying for assistance for a child or if you are pregnant, you may apply for the Maryland Children’s Health Program (MCHP). If you are applying for assistance with paying your Medicare premiums, co-payments or deductibles, you may apply at your DSS for the Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary Program (SLMB). All applications for these programs are available using the website above.

Delaware Programs – https://assist.dhss.delaware.gov

Virginia Programs – www.dmas.virginia.gov

In the event that you have applied for and provided all necessary information but still do not qualify for the programs above, you may be eligible for the Peninsula Regional Medical Center’s Financial Assistance Program. Applications may be taken orally by calling 1-877-729-7762 between 8:00 a.m. and 5:00 p.m. Monday through Friday. You may also visit the Financial Counselors located in the Frank B. Hanna Outpatient Center lobby between 8:00 a.m. and 4:00 p.m. Monday through Friday.

You may also visit the following websites for more information :

https://www.peninsula.org/patients-visitors/patient-forms

https://www.peninsula.org/patients-visitors/billing-center

https://www.peninsula.org/patients-visitors/billing-center/billing-information

Applications are available in English and Spanish.