Understanding Your Bill

Short Overview

We Bill Your Insurance Directly

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For services typically covered by insurance, we will bill your primary insurance company and, if applicable, your secondary insurance company (including Medicare and Medicaid). Please remember that health insurance coverage varies, so some services may not be covered. If you have questions about your health insurance coverage, please call your insurance company before receiving care at Duke so you fully understand how your policy works.

If You Don't Have Health Insurance

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If you don't have insurance or other third-party coverage, you will get a discount equal to the best discounts offered to insurance companies. The discount is automatically applied to your bill. Duke Health uses the Look Back method to calculate this discount. For more information on the current discount percentage and how it was calculated, please submit a request in writing to:

Duke Patient Revenue Management Organization (PRMO) 
PO Box 110566
Durham, NC 27709

Billing Statements

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You will receive monthly bill(s) for amounts greater than $10 that Duke Health determines are your responsibility after any insurance plan payments have been applied.

You may receive more than one bill for your hospital or clinic visit, due to the many different physician groups and hospitals within the Duke Health system. 

At the top of each bill, you'll see which Duke Health provider the bill is from, such as: 

  • Duke Private Diagnostic Clinic (PDC)
  • Duke Primary Care (DPC)
  • Duke University Hospital
  • Duke Regional Hospital
  • Duke Raleigh Hospital

Depending on the type of facility or provider, the bill may include different items and services.

Surprise Billing / Facturación sorpresa

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"Surprise billing" is an unexpected medical bill which happens when you cannot control who is involved in your care. Learn more about when this can happen and your protections against unanticipated medical charges.

La “facturación sorpresa” es una factura médica inesperada saldo que ocurre cuando no puede controlar quién participa en su atención. Obtenga más información sobre cuándo puede suceder esto y sus protecciones contra cargos médicos imprevistos.

Hospital-Based Clinics

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For clinics under the management of Duke University Hospital, you may see a charge on your bill for the equipment, supplies, and services provided in the hospital‐based clinic. These charges are separate from the services provided by your physician/provider. Any amount you owe will be based your specific insurance plan. Please contact your insurance company for information about your plan's coverage and what you owe.

Bills for Physician Services

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Bills for physician services from the Private Diagnostic Clinic and Duke Primary Care will include but are not limited to:

  • Examinations
  • Interpretations of tests
  • Surgical procedures
  • Consultations performed by physicians and, in some instances, physician assistants and nurse 
practitioners 

Physician services also include, but are not limited to, the services of anesthesiologists, psychiatrists, podiatrists, radiologists, and pathologists. These services may be provided in clinics or in the hospital but will be billed by the physician group.

Community‐Based Physician Bills

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You may receive separate bills from certain community‐based physician groups that provide professional services and bill separately from Duke. Please contact these physician groups separately with any questions.

Duke HomeCare & Hospice

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You may receive bills from Duke HomeCare & Hospice (DHCH), which is our provider for home health, infusion, and hospice services. For questions related to DHCH bills, please call 919‐620‐3853.

Hospital Bills

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Bills from hospitals include, but are not limited to, the following services: 

  • Laboratory
  • Radiology and other testing services (referred to as ancillary services)
  • Operating room services
  • Emergency
  • Pharmacy
  • Medical supplies
  • Inpatient room and board
  • Other services provided by the hospital 


You may receive a bill each time you visit the hospital.

Itemized Statements for Attorneys

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If services billed on your account are the result of an automobile accident or other accident caused by another party, you can request that itemized statements be sent to any attorney involved in the matter. 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.

Questions About Your Bill?

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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.

Download Our Patient Billing Brochure