Paying for Health Care Services

If you are a member of a Health Maintenance Organization or Preferred Provider Organization, your HMO or PPO plan may have special requirements, such as precertification or preauthorization 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.

Some Riverside locations function as outpatient departments of one of our hospitals. 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.

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 copayments also are the responsibility of the patient.

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. 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.

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 assistance for those that qualify. A partner of ours, HealthFund Solutions, is available to assist those with financial needs obtain health insurance through the marketplace.

Our Customer Service team can answer many of your questions regarding your hospital bill and can help you coordinate your billing and insurance needs. Please call 1-800-621-7677 for information or email [email protected].

This information relates to non-emergent health care services you may receive at Riverside Health System. You may receive services at a Riverside facility from provider groups that will bill you separately from Riverside Health System. Some health care services that you receive may be from a provider who does not participate with your managed care plan or insurance company.

The provider groups listed below provide health care services at Riverside Health System. You should contact your managed care plan or insurance company to find out if they are in-network providers. You should also ask if you will have to pay more than your deductible, copayment or coinsurance for health care services you receive from providers groups that are not in-network providers.

• American Medical Response
• Genomic Health
• Irhythm
• LabCorp
• Life Evac of Virginia
• Mayo Clinic
• MD Associates
• Medicomp
• Night Hawk
• North American Partners in Anesthesia
• Peninsula Pathology Associates
• Peninsula Radiological Associates
• Quest Diagnostics
• Shore Transport Services
• SME, Inc. USA

Virginia law (VA. Code §32.1-137.05) requires every hospital to provide, if you ask for it, an estimate of what you will have to pay for a scheduled elective procedure, test or service. Either the patient or their legally authorized representative can ask for this estimate. The law also requires every hospital to tell patients in writing of their ability to request this estimate of the payment amount pursuant to the law.

As required by law, we are providing you with notice that if you have been scheduled to receive elective services at Riverside Health System, you have the ability to request an estimate of the payment amount for which you will be responsible for such elective services.

To obtain an estimate of the payment amount or if you have a question about this notice, please call 757-989-8830 Option 4.

If you are covered by insurance, we recommend you contact your managed care plan or insurance company to find out if the elective service you are scheduled to receive is a covered service and what your actual out-of-pocket cost will be after your benefits are applied, including any applicable cost-sharing requirements.

The machine-readable file (MRF) requirement under the Transparency in Coverage (TiC) rules went into effect July 1, 2022. This part of the rule requires that insurers and self-funded group health plans must begin to publicly post machine-readable files with detailed information on the costs of covered services and prescription drugs.