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.