When you register or are admitted to the hospital, you will be asked for your insurance information and to sign an authorization to bill your insurance. It is our policy to collect any estimated self-pay balances or co-pays upon admission. This begins the billing process. We will file all hospital-related medical claims with your insurance. Because insurance coverage varies, we automatically bill your claim for the full amount. You will receive a bill for any outstanding balance.
If you have a managed-care plan, you may need prior authorization or pre-certification for treatment. Please discuss this in advance with your physician and contact your insurance company to ensure treatment coverage. In some cases, managed-care plans will not pay for hospital costs if patients do not pre-certify before coming to the hospital. Our filing of claims with your insurance company does not guarantee coverage.
During your visit to the hospital, you may experience a variety of tests, procedures and services. Many of these services are performed by health-care providers who work in the hospital but bill for their services separately. After your visit, you may receive bills from several different health-care providers, such as your anesthesiologist, radiologist, pathologist, ER physician and your physician.
If you have questions about your bill, call the business office Monday through Friday during regular business hours, or follow this link to contact us online. Your questions, comments or requests for more information are always welcome.
- Texas Health Partners Business Office
- Q: Are itemized statements automatically sent to patients?
- A: No. We send summary bills to the patient. To request an itemized statement, call the business office at 1-800-715-7210 or email CustomerService@texashealthpartners.com.
- Q: Can I make an appointment to talk to someone in person about my bill?
- A: Yes. You can schedule an appointment by calling the business office at 1-800-715-7210 or email CustomerService@texashealthpartners.com.
- Q: I could not find my question on this list. How do I get answers?
- A: To speak to a business office representative, call 1-800-715-7210 or e-mail CustomerService@texashealthpartners.com.
- Q: If I have an HMO policy, can I be billed if they do not pay?
- A: If you have an HMO policy, you should only be billed for the amount specified on your explanation of benefits (EOB) that is provided to you by your insurance carrier. This usually includes co-pay amounts.
- Q: What are my payment options?
- A: You may pay by phone with a check or credit card. Call 1-800-715-7210 to pay by phone or make payment arrangements.
- Q: What health plans are honored at Texas Health Partners facilities?
- A: The information on this list is subject to change at any time and without notice. Please contact your health plan to confirm a facility's continued participation in your particular network. When you make network and physician choices, we hope you will remember the high patient satisfaction ratings and perceptions of quality care at Harris Methodist, Presbyterian and Arlington Memorial hospitals. The hospitals honor more than 115 health plan choices, including: Aetna Health Plans, United Healthcare, Blue Cross and Blue Shield, Cigna Health Plans, North Texas Healthcare Network, Unicare, Private Health Care Systems, Beechstreet, Pacificare and Secure Horizons.
- Q: What if there is an error on my bill?
- A: If you have questions about your bill, or believe that it is incorrect, call the business office at 1-800-715-7210 or e-mail CustomerService@texashealthpartners.com.
- Q: What is a co-payment?
- A: Co-payment is a set fee the member pays to providers at the time services are provided. Co-pays are applied to emergency room visits, hospital admissions, office visits, etc. The cost is usually minimal. The patient should be aware of the co-payment amounts prior to services being rendered.
- Q: What is a deductible?
- A: Deductibles are provisions that require the member to accumulate a specific amount of medical bills before benefits are provided. For example, if a member's policy contains a $500 deductible, the member must accumulate and pay $500 out of pocket before the insurance carrier will pay benefits. Once the patient has met their deductible, the carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are yearly, usually starting in January.
- Q: What is co-insurance?
- A: Co-insurance is a form of cost sharing. After your deductible has been met, the plan will begin paying a percentage of your bills. The remaining amount, known as co-insurance, is the portion due by the patient.
- Q: Why am I being billed for Anesthesia?
- A: The physician anesthesiologist is independent from the hospital and will bill through his or her billing agent. In the event your insurance carrier does not cover these charges, it is the patient's responsibility to pay the charges. Prior to having services rendered requiring anesthesia, contact your insurance carrier to ensure that the anesthesiologist you have been assigned is a contracted provider.
- Q: What is the difference between an HMO and PPO?
- A: HMO stands for Health Maintenance Organization. An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals. PPO stands for Preferred Provider Organization. As a rule, you must select a primary care physician (PCP) who is under contract with the PPO. If you choose a doctor not under contract, you pay more. Like an HMO, you usually pay a small amount known as a co-pay each time you visit your PCP or health-care facility. Unlike an HMO, if you choose to see a doctor who is not contracted with the PPO, the plan might pay a percentage of the medical bills (out-of-network benefits). However, your cost will probably be higher than if you choose a caregiver that is in the plan's network.
- Q: Why did my insurance only pay part of my bill?
- A: Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services. Please contact your insurance company for specific answers to your questions. You may have out-of-pocket expenses.
- Q: Why do I get so many bills for my hospital visit?
- A: Emergency room doctors, pathologists, radiologists and primary care physicians are all independent providers. They bill separately from the hospital.
- Q: Why do I need to call the insurance company if they do not pay the bill?
- A: If you have a PPO policy, you are ultimately responsible for the total bill or any portion of the bill your insurance carrier does not pay. The Central Billing Office will make every effort to resolve the account balance with your insurance carrier. Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance.
- Q: Will my insurance plan pay for my treatment?
- A: You need to begin by verifying that your insurance plan is honored at the facility where you are being treated. Each insurance plan is different, and even within the same company one plan may cover a certain treatment while another does not. Furthermore, participation in a plan by a Texas Health Partners facility does not guarantee that it is approved for all services. Contact your specific insurance plan to verify whether your treatment will be covered.