Click here to return to the LMHS Home Page
 
Patient Billing Home Get Personalized Help Frequently Asked Questions Glossary

Private Insurance

Our hospitals, outpatient centers and affiliated physicians accept most insurances, but depending on your coverage, we may be considered "out of network." Depending on what your plan covers, you may be responsible for part of your hospital bill. Some insurers may require that you pay your bill and then submit it directly to them for reimbursement. Contact your insurance company to confirm what it will cover for your stay at one of our hospitals.

Explanation of benefits
Your insurance company may send you an explanation of benefits (EOB) showing the portion of our charges that it paid on your behalf. This is not a bill. You will receive a bill from us if you have a remaining balance after your insurance company's payments have been applied.

Written off charges
Insurance companies negotiate discounted rates for medical services and procedures. This rate may also be called an "allowable amount" or "amount allowed." If the discounted rate is less than the amount we charge for a service or procedure, the difference is written off meaning you aren't expected to pay it.

If you have a copay or coinsurance that applies to a service or procedure, the insurance company will reduce its payment by that amount.

Here's an example:
X-ray Scan Imaging  
Our charge $323
Insurance company's allowed amount. You have a co-insurance liability of 20%. $254
Insurance company pays 80% of allowed amount -$196
You pay remaining 20% of allowed amount -$49
We write off the difference between our charge and insurance company's allowed amount -$78
Zero balance 0

Disputing denied claims
If your insurance company denies the claim we file on your behalf, you may be sent a bill. If you believe your claim should have been approved, follow your insurer's appeal or dispute process. Click here for a sample letter of appeal.

home  |  about us  |  services  |  locations  | employmentpatient billing  |  press room  |  events  |  foundation

HIPAA | privacy policy | did you find it? | medical staff | send a link | get well card