Before Scheduling Your Hospital or Clinic Visit
Before you make an appointment, here are a few steps that can help you avoid surprises.
Review our list of specific health plans accepted by Duke Health.
This page includes information on health insurance plans, national transplant networks, and Medicare Advantage plans. We make every effort to keep this information current. However, it is subject to change at any time without notice.
Check with your health plan or employer to understand:
- Whether Duke Health is considered "in-network" for your health plan
- What amounts, if any, your insurance will cover if you receive care at Duke
- What deductible, copayment, or coinsurance amounts you may be responsible to pay
- If your estimated payment due will be greater than $250
- If you need prior authorization for elective services
- If you are required to get a referral from your primary care provider before seeing the Duke Health provider you plan to see.
- If and what you will be required to pay at the time of service (if your health plan decides that your service was not medically necessary, is a pre‐existing condition, or is not a covered service).
To speed up your check‐in process, you may pay your estimated balance due prior to your date of service.
At the Time of Your Hospital or Clinic Visit
Please bring your complete health insurance information and present it when you check in or register. This includes:
- Personal identification
- All insurance cards
- Any authorization forms, such as a referral
When you check in, please let us know if any of your information has changed, especially your:
If we don't have your current information, it can cause payment delays or denials that may ultimately leave you responsible for paying the insurance company's portion.
Expect to be asked for required payments such as:
- Balances from previous services
- Copayments for both physician and hospital care
- Estimated coinsurance or deductibles as required by your health plan
- Deposits or full payment for certain services not covered by insurance
You can pay by cash, check, or credit card.
Depending on the type of visit, you may also be asked to sign some forms, such as a document allowing us to release information to your insurance company. The person who consents to medical treatment, including the legal guardian of a child, will be financially responsible for the bill.
For Medicare Patients
By law, we must ask you a series of questions at each visit. The questions help us determine whether Medicare or another payer should be filed as your primary insurance. You will be asked:
- Your status, including other insurance you may have
- Your retirement date
If you are covered by Medicare, we will submit your claims to Medicare on your behalf. We will also ask you to sign a notice that holds you financially responsible for the services we provide to you. This is just in case Medicare deems the services not medically necessary and does not cover the services.
- Expect a bill to you and/or your supplemental insurance carrier for services not covered by Medicare, such as medications you give yourself and routine health exams.
- Expect to pay if Medicare or your supplemental insurance does not cover the services we provided.
Need help with your bill? Call Customer Service at 919-620-4555 (local) or 1-800-782-6945 (toll-free). Hours are 8:00 am to 5:00 pm Monday, Tuesday, Wednesday, and Friday and 8:00 am to 4:00 pm Thursday.