What Duke Will Do for You

Duke’s commitment is to provide care to all patients with a high level of dignity, respect, and skill.

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 and Financial Care Counselors can assist you with filling out applications for government-sponsored programs and describing monthly payment plans and other financial assistance programs available for those patients who meet certain financial criteria.

Charity Care Eligibility

Patients who do not have insurance and receive treatment at a Duke University Health System (DUHS) facility may receive discounted services under DUHS' charity care policy.

Medical treatment that is either urgent or provided on an emergency basis is eligible for a charity care discount under the DUHS charity care policy. Examples of this type of treatment include:

• Treatment provided in a DUHS Emergency Department
• Treatment provided in an inpatient setting following an urgent admission to a DUHS hospital
• Follow-up treatment to services provided through the Emergency Department once a follow-up visit and evaluation has occurred with a Duke physician

Cosmetic, transplant, experimental, and elective services are not eligible for a charity care discount.

Patients may receive up to a 100 percent discount on eligible services. Discount amounts are based upon a patient’s adjusted gross income compared to percentages of the current Federal Poverty Income Guidelines.

Patients who have large medical bills after insurance pays may also be eligible for charity care discounts. These medical hardship situations impact a patient’s ability to pay for basic living expenses and are evaluated on a case-by-case basis.

Applying for Charity Care

To qualify for a charity care discount, a patient must provide the necessary information and documentation to determine whether any form of outside financial assistance is available. Patients may be denied charity care if they or their family fails to cooperate with this process.

For care provided through the Emergency Department, no formal application is required. During the Emergency Department visit, financial counselors will meet with patients to determine whether there are any outside forms of financial assistance, such as Medicaid, Crime Victim, or the Cancer Control Program, available to pay for services.

If outside financial assistance is not available, a charity care discount will be provided automatically based upon the patient’s reported income level.

For other eligible inpatient and outpatient services, DUHS financial counselors will assist patients in applying for outside forms of financial assistance or charity care during the patient’s stay or visit.

If you believe that you qualify for charity care or other forms of outside financial assistance but have not spoken with a financial counselor or received a discount, please contact Customer Service at 919-620-4555 or 800-782-6945.

Prompt Payment Discounts

A 30 percent prompt payment discount is available to all domestic uninsured patients. This discount applies to all services except cosmetic services. No application is required.

The discount is available for all payments made in full prior to service through 60 days after the date of the patient’s first bill. This discount is automatically applied to the total statement balance.

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 Duke.

Statements for Unpaid Balances

Collection Process

Patients receive monthly statements for amounts greater than $10 that DUHS determines are the patient’s responsibility, either after insurance has paid or for patients without insurance.

Patients will be contacted four times (statements, phone calls, and e-mails) during a 120-day period reminding the patient of his or her bill. During this period, patients are expected to pay their bills in full or to establish a payment plan.

If the balance is unpaid after the 120-day period, the account will be sent to a collection agency. Six months after collection agency placement, the patient’s credit will reflect the unpaid bill.

In select cases, DUHS may choose to engage an attorney in a collection action. This step would occur only after DUHS has thoroughly reviewed the account and determined that the patient is not eligible for charity care or other forms of assistance.

Payment Plans

DUHS offers interest-free payment plans up to five years in length, depending upon the balance of the account. Payment plans may be established prior to, at the time of, or after services have occurred. For payment plans established prior to or at the time of service, the first month’s payment must be made to establish the plan and the patient must not have any outstanding bills with DUHS.

Please contact Customer Service at 919-620-4555 or 800-782-6945, contact a Financial Care Counselor at one of our locations, or visit healthview.dukehealth.org to establish a payment plan.

Financial Brochure

Please refer to our brochure (PDF, 456 KB), which provides more information on insurance and the patient billing process.

Methods of Payment

For your convenience, we accept cash, checks, and all major credit cards for payment. Payment is due 15 days after you receive a statement.

Overpayment Questions

Please contact Customer Service at 919-620-4555 or 800-782-6945 if you have any questions regarding overpayments. If applicable, we will apply any overpayments to any of your other outstanding balances.

Itemized Statements for Attorneys

If your account is a result of an automobile accident or other accident caused by another party, you can request itemized statements to be sent to any attorney involved in the account.

However, you will remain responsible for making payment on the account until the dispute is settled. We will follow all regulations related to accident coverage for patients covered by Medicare or Medicaid.