Frequently Asked Patient Questions
Insurance and Patient Billing
We know that healthcare bills can be confusing. We have compiled some of the questions most often asked by our patients and hope the answers will help you better understand healthcare billing.
It has been several months since I saw my physician, why am I only now receiving a bill?
Some insurance plans take up to 90 days or longer to process a claim. A balance due statement will not be sent to you during this process. Upon receipt of payment from your insurance carrier, you will receive a bill from our office for any remaining balance which will also include details of your insurance payment activity and other useful information.
I paid my hospital bill, why are you also sending me a bill?
If you have any procedure performed at the hospital, you will receive two bills,one from the hospital and one from our office. We are not associated with the hospital for billing purposes.
When do I become responsible for paying my bill?
You are responsible for your bill at the time you receive services from the provider and after response from insurance. We request that all patient balances be paid upon receipt of their first billing statement. Copays are always due when checking in for your visit.
How do I get copy of my bill?
For an itemized statement, please contact our office at 270-753-2444 and we will be happy to provide.
What if I find an error on my bill?
Please contact our office at 270-753-2444. We will be more than happy to review your claim and answer any questions you have.
How can I check on the status on my claim?
If it has been at least 30 days since the date of service, you may contact your insurance carrier directly for the status of your claim. After speaking with your insurance carrier, if you still have questions regarding your claim, please feel free to contact our office at 270-753-2444.
What is a “guarantor”?
The guarantor is the person legally responsible for all charges incurred by the patient. If the patient is over the age of 18 at the time services are rendered then they most often are listed as their own guarantor.
Why didn’t my insurance cover all charges?
Once your insurance carrier pays their portion of the bill, they will send you an explanation of benefits (EOB) to show how the claim was processed. How the carrier paid the claim is based on their contract with us and their contract with you. If you feel the insurance company should have paid a different amount, please contact them directly for resolution.
I received a letter from my insurance company asking me if my visit was related to an accident. I have not been involved in an accident, what should I do?
Medical treatment related to an accident is often covered by auto or a workman’s compensation insurance. Health insurance plans often verify if your medical expenses should be billed to another insurance company. If you receive such a request from your insurance carrier, please complete and mail the questionnaire back to your insurance company. If you do not respond, your claim will be denied and you will be responsible for payment.
Do I have to pay my co-payment at the time of service?
Yes, your co-payment is due at the time service is provided. You may also wish to pay your bill online.
Can I pay with a credit card?
Yes. Please fill out the appropriate information on your bill and mail back to us. We accept MasterCard, Discover, and Visa. You may also telephone our office at 270-753-2444 and we will be happy to process your payment or for convenience simply use our Online Bill Pay option.
What if I can’t pay my bill? Can I pay in installments?
We are happy to set up a budget plan for patients. The requirements are a first payment to start the budget plan and we will extend for 6 months. As long as a payment is made each month, no outside collection activity will be taken on the account. If you need to miss a payment or have forgotten a payment, please contact our office immediately so we can make note and re-establish your budget plan. The budget will be set up for the amount of your account when the budget is established.
What part of the balance am I responsible for when my insurance doesn’t cover services?
If there is a balance that was not covered by your insurance, then you are responsible for the balance due as soon as you receive your first statement.
My insurance information is incorrect on my bill.
Please contact our office during our normal business hours of 8a.m.to 4p.m. Monday through Friday at 270-753-2444. We will make the necessary changes to your account and re-bill the corrected insurance plan.
How do I know if my insurance company will cover my visit/services?
Coverage varies with each insurance company and by medical treatment. We encourage you to check with your insurance company prior to services.
How will I know if my insurance company has paid my bill?
Your insurance carrier will send to you an explanation of benefits detailing how your claim was processed and how it was paid. Any portion of that billing that they assign to you will be sent to you in the form of a statement.
Who do I contact to update and/or re-bill my insurance?
You may call our office at 270-753-2444. Please have your insurance card available when you call.
What should I do if my insurance denies my claim?
If you feel your claim has been denied in error, contact your insurance carrier for a detailed explanation on the claim. West Kentucky Surgical, Inc will also receive an explanation of benefits (EOB) from your insurance company stating the claim has been denied.
Do I have to pay my co-payment at the time of service?
Yes, you are required to pay your co-payment at the time of service. This is part of your agreement with your insurance company.
Why do you need my insurance card?
Your insurance card indicates the billing name of the insured, but also provides other critical data for billing purposes such as: policy number, group number, plan codes, effective dates, co-pays, deductibles, referral/authorization information, physician phone numbers, insurance company phone numbers and other important information.
What insurances do you accept?
West Kentucky Surgical, Inc accepts Medicare, Medicaid, and most major insurance carriers. Please contact your insurance carrier directly and prior to services for a specific list of participating physicians.
I have health insurance in addition to Medicare. Will you bill the other insurance company also?
If you have provided us with an insurance that is secondary to Medicare we will also bill that insurance after Medicare makes their payment.
What is the difference between Part A and Part B Medicare Coverage?
Part A covers inpatient hospital stays and Part B covers outpatient and physician services.