How Billing and Insurance Work
Medical billing and insurance are complicated. The billing process starts the moment you make an appointment or receive care and continues until the bill has been paid. Different insurance plans have different rules about what services they cover, how much they will pay, and under what conditions. The entire process is complex and involves many different people and departments. It can feel overwhelming! At [Client Name], we want to help you understand how it all works so you can get the care you need. To learn the basics about how billing and insurance work, explore the resources below.
Reading Your Statement
To review your Humboldt Park Health account, including your open balances and payment options, log in to the EquityPay portal. If you need help reading a statement you received in the mail, visit the How to Read Your Statement page.
Common Billing Questions
Here are three questions to ask to help determine whether insurance will help pay for your care. You can learn more about these topics by logging in and visiting the Learning Library.
Who is responsible for billing my insurance company?
For services covered by insurance, your provider will bill your insurance company.
Will I receive more than one bill?
You may receive bills from multiple providers for a single visit. For example, you will always receive a bill after you are treated at the hospital. However, most doctors who take care of you at the hospital are not employed by the hospital. This means their services are not included in the hospital bill. Most of the time, these charges are billed separately.
Who do I contact if I have a question about a bill?
You can learn more about your Humboldt Park Health bill by logging in to the EquityPay portal. If you still have a question, you may contact us by submitting a message in the EquityPay portal, or by [calling XXX-XXX-XXXX to speak to an account specialist.]
Common Insurance Questions
Here are three questions to ask to help determine whether insurance will help pay for your care. You can learn more about these topics by logging in and visiting the “Learning Library”.
Is my insurance “in-network”?
When a healthcare provider is “in-network,” they have a contract with your insurance company and have agreed to be paid a certain amount for their services. Typically, you pay less when you visit in-network providers because your insurance covers a higher portion of the cost.
An “out-of-network” provider does not have a contract with your insurance company and has not agreed to a set rate. Your insurance may cover a smaller portion of the costs or none at all. You typically pay more out of pocket when you visit out-of-network providers.
The only way to be sure which providers are “in-network” for your plan is contact your insurance company. You can view a list of the most commonly accepted insurance plans at [INSERT CLIENT NAME] by visiting the Accepted Insurances page.
Does my insurance cover the service I want to receive?
Each health insurance plan has its own rules about which services are allowed and in which situation. Covered services are those that are included in your plan and for which insurance may help pay.
Non-covered services are those that are not included in your plan. Insurance will not pay for non-covered services, so your provider will bill you for the full cost.
Before you visit your doctor, contact your insurance plan to confirm which services are covered.
When does my insurance require me to notify them or get an authorization?
In some cases, insurance will only pay for a service if they approve it first. This approval is called “authorization .” To determine which services require authorization, contact your insurance plan before receiving care.
In addition, some plans may require you to notify them within a certain timeframe after you visit an emergency room.