Heritage Valley will directly bill your insurance company if you have medical benefits through any type of individual, group, employer-based, or government-funded plan. We will also submit bills on your behalf to auto or workers’ compensation companies or other medical benefit programs if we are made aware of their financial responsibility.
The bill generated by Heritage Valley will only include services rendered by employees of the hospital or outpatient test center and will not include services rendered by caregivers such as but not limited to anesthesiologists, surgeons, radiologists, pathologists, attending or consulting physicians, or emergency department physicians. These caregivers’ fees are billed separately by those who perform the services.
Once your insurance company has reviewed and processed your claim, the hospital is notified. Your insurance coverage dictates how much your insurance company pays and what portion of the bill is your financial responsibility. Most insurance companies also send this notification to the patient or the subscriber and typically refer to this notification as an EOB (Explanation of Benefits). It is imperative that patients/subscribers understand their own insurance coverage and any policy limitations they have agreed to by enrolling with that particular plan.
Upon receipt of this notice and/or payment from the insurance carrier, the Heritage Valley billing staff will adjust your balance to the amount you owe (per your insurance company) and will send you a statement requesting payment. Payment to Heritage Valley is due within 30 days of the date of your billing statement. See the Pay My Bill link for information on payment options.
Some insurance companies require Heritage Valley to collect co-payments from patients for specific types of medical services. While co-payments are most commonly associated with emergency department visits, behavioral health visits and outpatient rehab (physical, occupational and speech therapy) visits, it is the insurance company’s prerogative to include or exclude various types of services from co-payment requirements.
Co-payments that are mandated by your insurance company are payable to Heritage Valley at the time of service. Co-payment amounts not only vary by insurance company, but they also vary by group or benefit plan. Your co-payment amounts are part of the benefit contract between you (the patient or subscriber) and your insurance carrier. All patients should be aware of their co-payment obligations prior to seeking services and should contact the insurance carrier or their employer with any specific questions.
Heritage Valley recognizes that not all patients are covered by health insurance or a government-funded program. For those patients who are not enrolled in any Medicare, Medicaid or other third party medical plan/programs, and who meet the required guidelines, Heritage Valley will reduce its charge for services, minimizing the uninsured patient’s financial burden.This reduction or discount is applied automatically upon verification that no insurance coverage exists and will
appear on the initial bill/statement as “Uninsured Discount.” Patients enrolled in any type of medical benefit/insurance plan or program are not eligible for the uninsured discount even if the service itself is considered non-covered or excluded from coverage. Contact any member of the staff at the Patient Billing and Payment Center for more details about qualifying for the uninsured discount. The department email is email@example.com.