The process for billing is initiated by the Admissions Department. Benefits and eligibility is verified by the Hospital and the health plans.
The Admissions Department obtains authorization from the health plan, which is required prior to transfer. Our case management department obtains ongoing authorization with the health plan’s Utilization Management Department.
The Admissions Department will check a Medicare patients full, coinsurance and lifetime reserve days. If Medicare does not cover 100% of the stay, a secondary insurance is identified or patient is notified of their financial responsibility for the co-pay portion of the bill. Physician billing is separate from the hospital billing. The Admissions office will facilitate a payment agreement for physician services.