Common Billing Questions
- What is a deductible? A co-payment? Co-insurance?
A deductible is the amount you pay each year before your plan begins paying benefits. This amount is usually a set dollar amount such as $250 or $500. A co-payment is a cost sharing agreement in which you pay a flat-dollar fee for a specific service. An example would be where the insurance plan charges a flat $50 co-payment for all emergency room visits. Co-insurance is the portion of your health care expenses that you are responsible for. If your co-insurance is 20%, then you would pay 20% of the expense after your deductible is met and your insurance company would pay the remaining 80%.
A co-payment is a cost sharing agreement in which you pay a flat-dollar fee for a specific service. An example would be where the insurance plan charges a flat $50 co-payment for all emergency room visits.
Co-insurance is the portion of your health care expenses that you are responsible for. If your co-insurance is 20%, then you would pay 20% of the expense after your deductible.
- What payment types are accepted for on-site payments, such as insurance co-payments?
University Hospitals doctors offices and facilities are no longer accepting cash or check as in-person payment for services, including insurance co-payments. You can pay by card (credit, debit, HSA, FSA, etc.) at the time of service. Apple Pay and Google Pay are available at select locations, and will be available to all locations beginning October 2023. Additionally, for many primary care offices, you can use UH MyChart to pay your bill online or before your appointment during eCheck-in. You will continue to be able to pay by check upon receipt of your patient statement after service is complete.
- What is the "Free Care Program" (HCAP - Healthcare Assurance Program)?
This program provides, without charge, certain basic medically necessary hospital services if you are a resident of the State of Ohio and are not enrolled in the Medicaid Program and your personal or family income is at or below the Federal Poverty Guidelines. Please refer to the HCAP link under Request Forms or call 1-866-771-7266 for additional information.
- What kind of charges/services are included in my hospital bill?
Your hospital bill reflects all the services you receive including charges for your room, equipment, supplies, diagnostic and therapeutic testing. It will NOT include any professional service charges rendered by your physician or by other health professionals. This may include Radiologists, Cardiologists, Emergency Room Physicians, Anesthesiologists or other specialists who diagnosis or interpret test results. These charges will be billed separately by those physicians or physician groups.
- What kind of charges/services are included on my physician bill?
Your physician bill reflects the services that are personally performed by physicians and other healthcare professionals such as advanced practice nurses, certified nurse midwives, physician assistants, clinical psychologist and others. These include the services for visits, procedures, surgeries and anesthesia as well as the interpretation of diagnostic testing such as those tests performed in radiology and specimens sent to pathology. It is very likely that a patient will receive a physician bill from a provider whose name they do not recognize due to all of the behind the scenes activity that occurs in providing quality healthcare.
- Who do I contact if I have a question or a problem with my hospital bill?
There are a couple of ways to contact us if you have a question or problem with your hospital bill. You may utilize our online free-form text, “Contact Us”, to submit your question or describe a hospital billing problem or you may contact Customer Service at 216-844-8299 or toll free at 1-800-859-5906, Monday – Friday, 8 a.m. to 5:30 p.m.
- Who do I contact if I have a question or problem with my physician bill?
There are a couple of ways to contact us if you have a question or problem with your physician bill. You may utilize our online free-form text, “Contact Us”, to submit your question or describe a billing problem or you may contact Customer Service at 216-383-0100 or toll free at 1-800-589-6006, Monday – Friday, 8 a.m. to 5:30 p.m.
- Who do I contact if I need to make changes or updates to my personal or insurance information?
Under “Common Request”, you can submit directly to the Customer Service Department any changes or corrections to your personal (i.e. address, phone number, name) or to your insurance information (primary or secondary). Please click on the appropriate link and follow the directions to submit your request.
If you prefer to contact Customer Service directly, call 216-844-8299 or 1-800-859-5906 between 9 a.m. – 4 p.m. regarding a hospital bill or 216-383-0100 or 1-800-589-6006 between 8 – 5:30 p.m. regarding your physician bill from University Hospitals.
- Who is responsible for billing my insurance company?
University Hospitals is responsible for for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company, therefore, you have the final responsibility for payment of your bill.
- Why am I being billed for "self-administered" drugs?
These are pharmacy charges that are non-billable to Medicare. Please refer to Medicare’s website for further explanation.
- What does "out of network" mean?
This typically means services were utilized by a provider that is not covered at the highest level or reimbursement per your description of benefits. Please refer to your description of benefits provided by your insurance carrier.
- When should my Medicare be billed secondary?
- Please refer to Medicare’s website for scenarios that fall into the guidelines for billing Medicare as secondary payer. www.medicare.gov/coverage or call 1-800-MEDICARE
- How will my payment be applied to my physician bill?
University Hospitals Medical Group posts patient payments based on “oldest” date(s) of service first. This is an automated process unless a special request is made to post the payment otherwise.
- Who do I contact if I need to discuss a quality of care issue?
Please contact the hospital Ombudsman or Patient Advocate.
- Who do I contact if I've been a victim of fraud regarding a hospital or physician bill?
Please contact the Customer Service information identified on the statement that you received.
- What is the "Uninsured Charity Assistance Program"?
University Hospitals is committed to treating all patients with dignity and respect regardless of their financial status or ability to pay. In support of this commitment, UH has established an Uninsured Charity Assistance Program. Through the program, UH provides discounts on hospital bills for Ohio residents who meet certain criteria. The amount of the discount is based on the patient’s or family’s income and Federal Poverty Guidelines (FPG). Please click Federal Poverty Guidelines for more information and to see if you qualify.