Paying For Your Health Care

Understanding Your Responsibilities and St Peter’s Commitment

Thank you for choosing St Peter’s as your healthcare provider.  

We understand that billing and payment for health care services can be confusing and complicated. We are here to assist you with information on how we process your bill(s).

The information below is designed to help you understand what we can do to assist you, what you can do to assist us and your insurance plan, and how we can help if you have difficulty paying your bills.

Your Responsibilities

Authorization of Services

Most health plans require authorization, particularly for elective services and may require you to notify your primary care physician.  It is your responsibility, with the assistance of your physician’s office staff, to obtain any preauthorization from your health insurance company. Failure to get the proper authorization may cause your insurance to pay at a reduced rate or denial of the claim. If your insurance company decides your service was not medically necessary, is a pre-existing condition, or is not a covered service, you will be asked to pay at the time of service.

Medicaid Passport Patients

There are services that require authorization from your primary care Physician prior to receiving those services.  You will need to check your Medicaid participant handbook to find the list of services and get the authorizations prior to coming for treatment.  Examples of this service are Physical Therapy, Speech Therapy and Emergency Room Treatment for certain health conditions.  If you are unable to locate this list contact your county case worker for the information.

When You Come to the Hospital or Clinic:

St Peter’s participates with most insurance companies, Medicare and Medicaid. Prior to your hospital or clinic visit, check with your employer or insurance company to see if you have access to health care services at St Peter’s, otherwise you may be responsible for all or a large portion of your bill.

Bring Your Health Insurance Information

Bring your complete health insurance information when you register. This includes identification, all insurance cards, and authorization forms. We will ask you to sign forms, such as a release of information, and possibly additional forms depending on your visit.

Inform us of Changes

If you are a current patient, please inform us if your personal or insurance information has changed since your last visit. The lack of current information can cause payment delays or denials that may ultimately leave you responsible for payment.

Making Co-payments

Co-payments for both physician and hospital care and other balances you may owe are due on the day you receive services. If your insurance requires it, you will need to pay for estimated coinsurance or deductibles related to your care. If you have any questions regarding your co-payments or deductibles, please call your insurance company.

Making Deposits

For certain procedures not covered by insurance, you may be required to pay a deposit or pay for the service in full prior to your care.

Consent = Financial Responsibility

The person who consents to medical treatment will be financially responsible for the bill, including legal guardians of a child.

Medicare Patients: What to Expect

If you are a Medicare patient, you will be asked a series of questions regarding your status including other insurance you may have; and your retirement dates. These questions are required by law and must be asked each time you visit us. If you are covered by Medicare, we will submit your claims to Medicare on your behalf.

When Medicare Doesn’t Cover a Service

Medicare requires that we provide only those services approved by Medicare as deemed medically necessary. In the event the service is not covered by Medicare, we may ask you to sign a notice that makes you financially responsible for the services provided. Additionally, we will bill you and/or your supplemental insurance carrier for services not covered by Medicare such as self-administered medications and routine health exams. However, if neither covers these services you will be responsible for payment for these services.

Workers Compensation, Auto Accident or other liability claims

Like any other insurance claim we submit, your liability insurance does require certain information on the billing form in order to pay the claim.  This includes but not limited to insurance name and address, insurance claim agent information, accident dates and claim numbers. At the time of admission you will be given a letter explaining the information that is required to bill your claim.  If information is not received by the time the bill is ready to send to your insurance a second request will be sent.  Communication on liability claims between the patient and their Patient Account Representative is very important.   Please help us help you to get your claim paid as quickly as possible by providing this information to us in a timely manner.   If you fail to provide all of the necessary information you will be responsible for payment in full on the account.

After your visit:

Respond promptly to requests from your insurance company for additional information. These requests must be handled before payment can occur.  Failure to respond may cause your claim to be denied by your insurance company.

We Bill Your Insurance Directly

For services typically covered by insurance, we will bill your primary insurance company, and if applicable, your secondary insurance company as a courtesy, including Medicare and Medicaid. It is important to remember that health insurance coverage varies and some services may not be covered. If you have questions regarding your health insurance coverage, please call your insurance company to better understand how your policy works prior to receiving care at St Peter’s.

Call Us With Billing Questions

If you have any questions about your bill(s), please contact our Patient Business Services Department and request to speak with a Patient Account Representative Monday through Friday from 8:00AM till 4:30PM. Please call 406-444-2185.  

Who Can Discuss a Bill

Confidentiality is important. Our Patient Account Representatives may only speak with the patient or the person designated in writing by the patient to receive the bill(s) on behalf of the patient. This is required by both federal and state law. Authorization of Disclosure of Healthcare Information

     

Have Your Statement on Hand

To help us answer your questions efficiently, have a copy of your statement, insurance card(s) and any additional information available. Please note call times are heaviest on Mondays.

Mailing Instructions

To ensure that we credit your account properly, tear off the bottom or top portion of your bill and mail it in the envelope provided. If paying by check, write your account number(s) on your check.

A Word About St Peter’s Billing Statements

You may receive more than one bill for your hospital or clinic visit from St Peter’s due to You may receive more than on bill fro your hospital or clinic visit from St Peter’s due to the many different physician groups and services available within the St Peter’s system.

We ask that you take a moment and verify all of the insurance information on the statement.  If you find that we have the incorrect insurance or insurance numbers please contact us immediately so that we can correct the information and resubmit with the correct information.

Each bill will identify who the bill is from and you will need to contact the appropriate billing entity.  The following is a list of St Peter’s providers:

St Peter’s Hospital

St Peter’s Physician Clinics

APEX of St Peter’s

Home Link/Hospice of St Peter’s

Community-based Physician Bills

In addition you may receive separate bills from certain community-based physician groups who provide professional services and bill separately from St Peter’s. Please contact these physicians separately with any questions.

Summary of Services

The first statement that you receive will be sent to you at the same time we bill your insurance. This statement will provide you will a summary of services provided to you or your family member.  If you need a more detailed break down of these services contact the Patient Account Representative listed on the bottom of the statement.

Statements for Unpaid Balances

If your insurance company does not pay the entire bill, we will send you a statement to notify you of any remaining unpaid balances.  Payments in full for all self pay balances are due within 30 days.  If you are unable to pay in full contact your Patient Account Representative.

Methods of Payment

For your convenience, we accept cash, checks, and all major credit cards for payment. Payment is due 30 days after you receive a statement.

Can’t Pay a Bill? We Can Help

Please tell us if you cannot pay your bill in full and let us help you. Our Patient Account Representatives can assist you by describing monthly payment plans and other financial assistance programs available for those patients who meet certain financial criteria.  They can also refer you to someone to help you fill out applications for government-sponsored programs.

Overpayment Questions

Please contact the Patient Business Services department if you have any questions regarding overpayments. If applicable, we will apply any overpayments to any of your other outstanding balances.