When You Come to the Hospital or Clinic
Duke 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 Duke, 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.
Co-payments, Deductibles, and Coinsurance
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 also need to pay for
estimated coinsurance or deductibles related to your care.
In most instances, you will be notified prior to your visit if your estimated payment due is greater than $250. To expedite your check-in process and for your convenience, you may pay this balance prior to your date of service.
If
you have any questions regarding your co-payments,
deductibles, or coinsurance requirements, 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.
Authorization of Services
Most health plans require authorization, particularly for
elective services, and may require you to notify your primary
care physician. 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.
Consent = Financial Responsibility
The person who consents to medical treatment will be
financially responsible for the bill, including legal guardian
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 date. 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 Medicare nor your supplemental insurance covers these services, you
will be responsible for payment of these services.
Financial Assistance or Payment Plans
If you anticipate problems paying your portion of your bill,
please let us know. We can help you apply for other types of
financial assistance or payment plans.
Please contact a Financial Care Counselor on your date oF service or call Customer Service at 919-620-4555 or 800-782-6945.
After Your Visit
Respond promptly to requests from your insurance company for
additional information. These requests must be handled before
payment will be made by your insurance company.
Call Us with Billing Questions
If you have any questions about your bill(s), please contact
our Customer Service Center and request to speak with a Patient
Account Representative Monday through Friday between 8 a.m. and 5 p.m. Please call 919-620-4555 or 800-782-6945 (if you live
outside of Durham).
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.
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 that call volumes 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.
