CHARITY CARE POILCY.PDF

FINANCIAL ASSISTANCE PROGRAM.PDF

IRS VERIFICATION OF NON-FILING, FORM 4506T.PDF

INFORMATION ABOUT YOUR BILL AND PATIENT FINANCIAL SERVICES

Our Mission: To provide an optimal quality, cost effective continuum of healthcare services to all citizens and visitors of Carteret County, ensuring a safe environment of respect, compassion, and dignity.

Carteret Health Care (CHC) understands that the cost of healthcare is a concern to our patients and we’re committed to providing outstanding customer service by assisting our customers with registration, billing and other Patient Financial Services in a timely, professional manner.

Insurance Information

As a courtesy to our patients, CHC will gladly file a claim with your insurance carrier. CHC is a contracted provider with Medicare, Medicaid, BlueCross/Blue Shield, Aetna, Cigna, United Healthcare, VA, Tricare, Medcost, Multiplan and many others. We will submit claims to all insurance plans even if we don’t have a contract with them.

Most payers have regulations such as prior plan approval, etc. for scheduled or elective services such as MRI, CT procedures, same-day surgery, etc. Please check with your Physician and/or insurance company prior to scheduling these types of services. Sometimes you may be financially responsible if the insurance company’s regulations aren’t followed. This generally does not apply to Medicare beneficiaries, however, it may apply if you have a Medicare HMO or Private-Fee-For-Service (PFFS) plan such as Humana Gold, Southeast Community Care, etc.

Medicare Information

Medical Necessity is a Medicare term that may not be familiar to you. Medical Necessity is a term hospitals and physicians use to indicate tests that Medicare will likely not reimburse. Here’s why: Medicare does not pay for all of your healthcare costs. They pay only for covered items and services when their regulations are met. The fact that Medicare may not pay for a particular item, or services, DOES NOT mean you should not receive it. There may be very good reasons why your physician recommended it. CHC encourages you to discuss any Medical Necessity or Statutory Exclusion concerns you may have with your physician in order to develop your best course of medical treatment.

If your physician orders a procedure or service that Medicare won’t cover, you’ll be asked to sign an Advance Beneficiary Notice (ABN). The ABN informs you in advance of your treatment that Medicare is not likely to pay for. By signing the ABN, you’re indicating that you understand and agree to be fully responsible for payment.

Notice of Exclusions from Medicare Benefits (NEMB)

There are items and services for which Medicare will not pay. Medicare does not pay for all of your health care cost. Medicare only pays for covered benefits. Some items and services are not covered Medicare benefits and Medicare will not pay for them.

When you receive an item or service that’s not a covered Medicare benefit, i.e. Self-Administered Drugs, you’ll be billed for these items and will be responsible for paying for them. Payment of deductibles, co-payments and other non-covered services are expected at the time services are rendered. These items are also typically not covered by a secondary or other insurance plan.

If you have questions regarding this Medicare policy, please refer to your “Medicare & You” book or contact the Medicare beneficiary hotline at 1-800-633-4227.

Medicaid

Carteret Health Care (CHC) will submit claims to Medicaid provided you supply the required information and/or verification of coverage is obtained through the Department of Social Services. You may be responsible for a portion of your charges if Medicaid makes that determination. If you don’t have medical insurance or feel you may qualify for Medicaid, CHC has a staff person on-site from the Carteret County Department of Social Services to assist with your Medicaid application.

Worker’s Compensation

If the services you’re requesting or receive are the result of a work-related injury, CHC will bill your employer or employer’s Insurance carrier if we receive verification from your employer that it’s work related. Otherwise, you’ll be responsible for the bill. We’ll also ask for your health insurance information in the event that Worker’s Compensation denies the claim.

Services Not Billed by Carteret Health Care

During your hospital stay, you may receive services from physicians and/or other healthcare providers who’ll bill separately for their services. CHC may provide your insurance information to these providers. If you have any questions about their bills, please contact them directly. Some of these providers may include:

Frequently Asked Questions (FAQs)

Where is the Patient Financial Services Department located?

The Patient Financial Services Department (PFS) is located on the first floor. You may also contact us at 252-808-6506.

How do I request an itemized statement?

You’ll receive a summary bill approximately 10 days after you’re either discharged as an inpatient or receive outpatient services. You may contact the Patient Financial Services department at 252-808-6506 to request a copy of an itemized statement.

Do you accept Debit/Credit Card payments?

We accept MasterCard, Visa and Discover. You may present your card at the cashier’s office in our Patient Financial Services Department, or you can complete the credit card section on the monthly billing statement. Additionally, you may call one of our Patient Account Representatives and we can also process your payment over the phone. 

What if I’m unable to pay my balance in full?

We at CHC have experienced Patient Account Representatives ready to assist you with financial matters whether establishing a payment plan or an eligibility determination for Medicaid or other government assistance programs. We also offer the following:

Prompt Payment Incentive Program

CHC offers a prompt payment discount for patients who either do not have any health insurance or on the balance after all insurances have paid their portion. You may contact one of our Customer Support Representatives at 252-808-6506 for additional information.

Financial Assistance

CHC has a Financial Assistance program to assist patients who may not be able to meet their financial obligations and are not eligible for other types of assistance. You‘ll be asked to provide tax documents, pay stubs and other information so we can determine how much assistance you may be eligible for. After the application is completed, it’ll be reviewed for eligibility. Based on your income and the CHC financial assistance guidelines, you may be eligible for a reduction or in some cases have your entire bill adjusted.

You may contact a Customer Service Representative in our Patient Financial Services Department at 252-808-6517 for further information about this program.