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.
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.
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, Advanced Patient Advocacy, is available to assist you in applying for Medicaid or other government assistance programs.
To help patients understand their personal out-of-pocket responsibility, upon request, the hospital will make available price quotes in advance of services being provided and in compliance with federal law.
So that estimates are as accurate as possible, please provide:
- Detailed description of the test(s)/procedure(s) being ordered by the doctor
- Doctor’s name and office phone number
- Insurance information (if any), including insurance company name and phone number, policy holder name, policy number and group number located on the insurance card.
The estimate will provide the patient with the following:
- The estimated financial responsibility for the procedure/services based on the average charge for the procedure/services.
- Patients with health insurance will be quoted an estimated amount that will be due to the hospital based on the deductible, co-pay or co-insurance amounts established by their health insurance plan.
- Patients who do not have health insurance will be quoted an estimated amount that will be due to the hospital that will include an uninsured discount to the estimate.
- Estimates will not include any services related to complications that may occur during the procedure/service. Also, charges for physician fees such as a, pathologist, anesthesiologist or radiologist will not be included. These charges will be billed separately by the specific provider. Due to these factors, estimates are not exact and cannot be interpreted as a bill or exact cost for services. Instead, this service is offered to help simplify the financial aspect of hospital visits so patients are able to focus on their healthcare.
For a Quote: please contact our call center at 1-800-621-7677 or 757-989-8830; option #3.
Hospital outpatient departments (provider based)
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.
- More about provider based offices
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 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 BillingHelp@rivhs.com.
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.