Paying for Healthcare Services

Health Insurance
If you come to Riverside for services, we will ask to see your insurance identification card and we will probably make a photocopy of it. All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the medical facility’s billing procedures and charges. Remember that your insurance policy is a contract between you and your insurance company and you have the final responsibility for payment of your medical fees.

HMO or PPO
If you are a member of a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), your plan may have special requirements, such as pre-certification or pre-authorization for certain tests and procedures. It is your responsibility to make sure that you meet the requirements of your plan. If you don’t follow your plan’s requirements, you may be financially responsible for all or part of the services rendered in the hospital.

Medicare
If you are covered by Medicare, we will need a copy of your Medicare card to verify eligibility and process your Medicare claim. You should be aware that the Medicare program specifically excludes payment for certain items and services such as cosmetic surgery, some oral surgery procedures and personal comfort items. Deductibles and co-payments also are the responsibility of the patient. Medicare does not pay for the cost of a private room unless medically necessary.

Medicaid
If you are covered by Medicaid, we will need a copy of your Medicaid card. Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary. If you have completed a Medicaid application with your local Social Services department and are awaiting an eligibility determination, please provide this information to the patient access or admissions staff.

No Coverage
If you have no insurance or your insurance will not cover the service you request, you can make payment by check, money order, cash or credit card, including VISA, MasterCard, Discover or American Express. We also offer financial coordinators who can discuss financial arrangements with you. A care coordinator, who is a representative of the Care Management Department, is available to assist you in applying for Medicaid or other government assistance programs.

Hospital Outpatient Departments (Provider Based)
Some Riverside locations function as outpatient departments of Riverside Regional Medical Center. You will also see these locations sometimes referred to as "provider based" or "hospital based" offices, even if they are not located within the hospital building. Depending on your insurance coverage, the amount you pay for services in a provider based setting may be different from what you would pay for services in an office that is not provider based.

Co-Payments and Deductibles
We will ask that you pay your co-payments and/or deductibles at the time of service or when you are admitted for your hospital stay.

Patient Billing Questions
Our patient accounting representatives can answer many of your questions regarding your hospital bill and can help you coordinate your billing and insurance needs. Please call (757) 989-8830, Option 3, for information.

Paying for Hospice Care
Hospice care is covered under most private insurances through the patient’s hospice or home health benefits plan. Please review your plan with your insurance carrier or case manager. Our staff can also assist you in investigating your coverage. Medicare, Medicaid and Champus also provide special “Hospice Benefits.” Riverside Hospice does not refuse care to a patient because of the inability to pay.

Paying for Home Infusion and Pharmacy Services
The reimbursement specialists at Riverside Home Care will coordinate direct billing to insurance companies and other payment sources. We will assist you in investigating insurance coverage for home care and will explain the billing for our services.


 

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