Common Billing Questions

Why do I receive separate bills from the hospital and from the physician?

When a physician specialist performs these services, he/she is generally required to submit their bill separate from the hospital’s bill.

For example, if you came to the emergency room and had an x-ray and laboratory tests, you may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting any x-rays, and a bill from the pathologist for analyzing any specimens taken.

I see the same item listed on the physician’s bill and the hospital bill. Why?

Every hospital visit involves both physician and hospital resources. Although the hospital and the provider may use the same language to describe each charge, their bills are for separate services. The physician’s bill will be for professional assessment, direction and oversight. The hospital’s bill will be for the technical resources, including procedures and equipment, medications and supplies.

Why did my insurance pay only a part of my bill?

Most insurance plans require that you pay a co-payment, coinsurance or deductible for your health care expenses. Contact your insurance company for specific information about your coverage.

Why did I receive a bill if I have insurance coverage?

You will receive a patient responsibility statement after your insurance processes our bill. The amount you are billed for is based on what your insurance communicates to us on an explanation of benefits (EOB). The EOB details how your insurance processed our bill and calculated your responsibility based on your individual insurance plan. If you believe your responsibility is not correct, please contact your insurer directly.

My insurance should have paid my bill, what should I do?

Please verify that your insurance carrier has received and processed the claim. If the claim has not been processed, then carefully review your insurance policy or contact your insurance carrier to determine if the services and procedures are covered. Your insurance carrier will have the most accurate and up-to-date information about your policy and your claim. If your insurance company has questions, please direct them to contact Customer Service at 1-877-870-6622 to verify that the most up-to-date insurance information is on file.

Why am I getting a bill now, when services were provided so long ago?

University Pediatricians will process and send a bill to a patient after payment is received from the insurance carrier and it is confirmed that the balance is owed by the patient. The length of this process depends on how long it takes to receive a response from your insurance carrier, and whether there is secondary insurance.