We realize that medical billing is very complicated. Pocono Medical Center has put together this information to assist you in making the best decisions for your care, and to help you to avoid any unpleasant billing surprises following your treatment.
If you have questions that are not answered in the list of Frequently Asked Questions (FAQ), please contact your insurer. You may also contact PMC's Customer Service Department at (570) 420-4923 from 8:00 a.m. to 4:30 p.m. Monday through Friday.
PMC Guide to your Hospital Bill
The patient is ultimately responsible for his/her hospital bill. We encourage you to confirm that your insurance covers PHS services ahead of time by calling the phone number listed on your insurance card.
The hospital said it would accept my insurance, but I still got billed for some services. Why?
Every insurance policy provides different benefits and maintains contracts with different healthcare providers. Even though Pocono Medical Center may have an agreement with your insurer, individual laboratories and physicians may not. In addition, you may still be responsible for a co-payment, a deductible, and any non-covered services.
Why did I receive four separate bills for my operation?
You probably received a hospital bill, a surgeon bill, a pathologist bill, and an anesthesiologist bill. Most physicians who treat you at Pocono Medical Center has his or her own business or "practice." These individual physicians each have their own billing offices. These practices may or may not accept the same insurance as the hospital, and even if they do, may not cover 100% of the charges. They also have their own contracts with insurance companies, which means that your insurance may not cover every doctor or service involved.
Who can tell me what my insurance covers?
The only way to find out exactly what your insurance will pay for is for you to call your insurer. You can find the number on your insurance card. It is important to discuss every aspect of your planned treatment with your doctor ahead of time, so that when you call your insurer you will be able to ask specific questions, such as:
- " Will my insurance pay for MRI scans?"
- " Will it cover pathology interpretation?"
- " What about follow-up care?"
Why can't the registration clerk who admits me tell me all this?
The registrations clerk who admits you doesn't know the details of your individual insurance coverage. That information is only available to you from your insurer or your employer (if you are insured through work.) You should contact your insurer before being admitted to the hospital to make sure that you will be covered. PMC has hundreds of contracts with insurance companies. Guidelines, requirements, and covered services in these contracts change constantly.