During or after your stay or visit, you may have questions about the bill you receive
from Memorial Hospital and from other medical professionals who provided care during
your hospital visit.
The Department of Patient Accounting makes every effort to keep our Hospital billing
process as "hassle-free" as possible. Still, we know the various insurance forms,
physicians' bills and hospital bills may be complex and confusing. Consequently,
we provide this information to answer some of the commonly asked questions.
Commonly Asked Questions
Who do I contact to find out how much my hospitalization
or test will cost?
You may contact our customer service line at 717-849-5432 for an estimate on simple
outpatient procedures. (Information for outpatient surgery and inpatient stays is
not available due to the complicated nature of these services.) Charges quoted will
be based on information you provide from your physician. This quote is an estimate
only and does not include charges for physician fees associated with the service.
When is payment of my bill due?
If you do not have insurance, we request full payment of the balance within 14 days
of receiving your bill unless alternate payment arrangements have been made.
How do I make financial arrangements on my bill?
The financial policy of Memorial Hospital is designed to allow anyone in need of
critical care and/or emergency health care to receive such care, regardless of financial
status or ability to pay. However, we ask for your cooperation in fulfilling your
financial obligation to Memorial Hospital by paying your bill promptly or contacting
your insurance carrier regarding payment.
Memorial Hospital accepts cash, checks and a variety of credit cards. If full payment
is not possible, you may meet the criteria for an installment plan or financial
hardship program. You will be asked to disclose certain financial information in
order to be eligible. Contact the Patient Financial Services (PFS) office at 717-849-5420
for more information. Arrangements must be made within 30 days of receipt of your
bill.
We also have on-site financial counselors available to assist you with your financial
options prior to admission or discharge. Contact the counselors at 717-849-5438
or 717-849-5422.
We also offer on-line credit care payment and check processing. These options may
be accessed through this website.
Will the hospital bill my insurance?
The Billing Office bills both primary and secondary insurance carriers. There are
a variety of plans and networks in existence so it is important to furnish complete
and accurate insurance information in order to expedite prompt payment. Always carry
your insurance card(s) and identification with you on each visit.
Will my insurance pay for everything?
There are many different types of insurance plans with a variety of coverage options.
Typical patient charges include co-pays and deductibles. These patient charges are
applicable even though the Hospital may have a contract with your insurance carrier.
How do I know the insurance carrier has received a bill
from the Hospital?
If your carrier does not process the claim within 30 to 45 days, you will receive
an invoice from the Hospital. We suggest you contact your insurance carrier if you
have any questions regarding payment of the bill. Encourage them to pay the claim
promptly on your behalf. Ultimately, you are responsible for those charges unpaid
by your insurance carrier.
How will I know the status of my account?
You, or the responsible guarantor, will receive monthly statements indicating the
status of your account, including any credits for payments you have made, contractual
adjustments and/or insurance payments. Please be aware that each time you receive
services from the Hospital, a separate account is created. It is possible to have
several accounts, with different account numbers, open at the same time.
If I have a concern with my bill, who do I call?
You may contact the Customer Service Representative at 717-849-5432 between the
hours of 7:30 a.m. and 4:30 p.m, Monday through Friday, or visit the office personally
between the same hours. The PFS office is located on the first floor right off the
lobby area.
Helpful Tip
Keeping track of the bills sent by various health care professionals and facilities,
as well as the information sent to you by your insurance carrier, can be challenging.
We suggest you keep these records in a separate file, noting the dates of service
and payments made for those services. Keeping records in one place will be helpful
in resolving billing questions and may also come in handy when it comes time to
file your income tax return.
Physician Bills
In addition to the Hospital’s bill, you may receive separate bills from your personal
physician, radiologist, anesthesiologist, emergency room physician and other consultants
or specialists that your attending physician chooses to involve in your case. They
will bill you directly for their services because they are in private practice —
they are not employed by Memorial Hospital.
The Hospital cannot control which insurance plans are accepted by the physicians
who provide services at Memorial. Therefore, you should discuss with your personal
physician, whether he/she can include in your care only physicians who accept your
insurance plans. Otherwise, you may incur additional co-insurance expenses.
Understanding Health Insurance
Terminology used to describe various aspects of a hospital bill can be confusing.
Here are some terms used frequently by Memorial Hospital and most health insurance
carriers:
Co-insurance:
The amount you are required to pay for medical care after you have met your deductible.
This rate is usually expressed as a percentage of covered charges, i.e. 20%.
Coordination of Benefits (COB):
COB eliminates the duplication of benefits when you are covered under more than
one group plan. Benefits under the two plans usually are limited to no more than
100 percent of the billed charges. Many insurance companies will not process claims
until they have COB information on file. Should your carrier request this information,
please respond immediately.
Co-payment (Co-pays):
Flat fee you pay every time you receive service. Most insurance companies have co-pays
for physician visits and emergency room visits.
Contractual Adjustments:
The difference between hospital charges and what the hospital is contractually obligated
to accept as payment from the insurance company.
Deductible:
The amount of money you must pay each year to cover your medical care expenses before
your insurance policy starts to pay.
Explanation of Benefits (EOB):
A form sent to you by your insurance carrier. It explains the amount of total hospital
charges covered by your policy, the amount of payment made and to whom, and any
deductibles or co-insurance.
Guarantor:
Individual financially responsible for payment of an account.
Health Maintenance Organization (HMO):
Prepaid health plans. You pay a monthly premium and the HMO covers the cost of your
physician visits, hospital services, etc. You must use the physicians and hospitals
designated by the HMO.
Inpatient (IP):
This refers to charges relating to an inpatient (or in hospital) admission.
Medicare Advantage Plan:
A replacement plan for traditional Medicare.
Medicare Carrier:
The company that processes Part B physician claims. HGS Administrators is the carrier
in the Greater York area.
Medicare Intermediary:
The insurance company the federal government contracts with to administer the Medicare
Program. Wisconsin Physician Services (WPS) is the company that is assigned to Memorial
Hospital.
Outpatient (OP):
This refers to charges relating to outpatient testing and/or outpatient surgery.
Preferred Provider Organization (PPO):
A combination of traditional fee-for-service insurance and an HMO. When you use
the physicians and hospitals that are part of the PPO network, your medical and
hospital bills are covered. However, you have the option of using physicians outside
the network, but at an additional cost to you.
Pre-existing Condition:
Health condition that existed before the date your insurance became effective. Many
insurance plans will not cover care related to pre-existing conditions. Some will
cover them only after a waiting period.
Primary Care Physician (PCP):
Family physician who monitors your health and diagnoses and treats any conditions
or illnesses. Your PCP may refer you to a specialist if another level of care is
needed. If you have an HMO, your PCP must authorize all services, including ER services.
Reasonable and Customary:
A fee some insurance carriers pay for a particular service. If your physician or
hospital charges more than the reasonable and customary amount, you may be responsible
for the difference.
Universal Billing Form (UB04):
Standard billing form required by Medicare and most insurance carriers to summarize
a patient’s hospital charges.