Duke University Health System (which includes Duke University Hospital,
Durham Regional Hospital, and Duke Raleigh Hospital) and the Private
Diagnostic Clinic provide estimates of patient liability after
insurance.
You may receive a phone call from one of our skilled financial
counselors or from our automated messaging system providing you an
estimate of your liability after insurance and assisting you with
payment or payment options.
Below are responses to the most frequently asked questions. If you need
more information, please ask to speak with a financial counselor.
Frequently Asked Questions
What is a deductible, co-payment, or co-insurance?
A deductible is the initial amount that you must pay before your
insurance plan begins to pay for your bills. Typically, a deductible is
a flat dollar amount.
A co-payment is a flat amount paid for each visit to a provider. If you
have a $50 hospital co-payment, you must pay $50 for each visit and
your insurance company will pay for the remaining balance on all
covered services. Co-pay’s may vary depending on the location of the
visit (i.e. urgent care, emergency department, outpatient hospital
clinic, and/or facility).
Co-insurance is the percentage amount you are liable for until you
have paid your out-of-pocket. Co-insurance amounts vary but the most
popular is a 20 percent co-insurance rate. After you meet your
out-of-pocket for that period of time, then most plans will pay at 100
percent.
In some instances, you may be responsible for a co-payment,
deductible, and co-insurance during the same visit. Check with your
insurance plan if you have questions.
Do I have to make a payment before I receive services?
It is our policy to collect all patient liable amounts prior to or
at the time of service. You may discuss payment options with a
financial counselor by phone when you are called or when you arrive for
your visit.
I had a visit last week -- why didn’t I get a call before that visit?
Currently we are providing estimates of patient liability in select
service areas where patients may experience higher out of pocket
expenses.
You may receive a call if you have a visit in the following service
areas at Duke Clinic, Duke University Hospital, or Durham Regional
Hospital: radiology, outpatient surgery, ambulatory surgery center,
admissions, cardiac catherization, cardiac diagnostic unit, or GI
procedures.
How do I know that the amount you estimated is the correct amount?
We are providing you with an estimate of your liability after insurance for the services to be rendered.
Insurance contracts vary a great deal depending on allowed services,
co-payment amounts, deductibles, and co-insurance. Because of this, it
is impossible to know exactly how much your insurance company will pay
or how much you will have to pay.
Please remember that this is only an estimate of your liability after
insurance. You will receive a statement of your actual charges,
insurance payments, and what you actually owe.
If I get a bill or statement after I pay for my future visit, who can I contact with questions about my statement?
Customer service representatives are available to help you. Please
call us at 800-782-6945 with any questions or concerns you may have
about your bill.
