"Pricing transparency" is the term used to describe initiatives in the health care industry to provide meaningful pricing information to consumers. The health care industry is often complex and difficult for consumers to navigate. Price transparency is a means of providing consumers price information on common services. Our ASC is committed to presenting pricing information in a way that will be easy for the consumer to access and understand, as well as to providing other useful information about financial assistance available, definitions of key terminology and key financial policies. Using the AHCA website, FloridaHealthPriceFinder, a consumer can determine national, state, and local pricing for a variety of health care services. Patients and prospective patients should recognize that the service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and that actual costs will be based on services actually provided to the patient.
What services are included in my hospital bill estimate?
Estimates provided includes estimated room and board (for inpatients), supplies, nursing care, equipment use, nutritional services and any services handled by the staff of the hospital within the walls of the hospital.
What services are excluded from my hospital bill estimate?
Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. This can include fees related to specialists, anesthesiologists, pathologists and radiologists. Independent laboratory and radiology services will also bill you separately for reading and interpreting EKGs, X-rays, EEGs and lab work.
What does "uninsured" mean?
It means that you have to pay for your services and that you do not have coverage for the hospital services by a third party like Medicare, Medicaid, Workers’ Compensation or an insurance company. Other common terms used when referring to uninsured patients are: self-pay and private pay.
When I call for a pricing estimate, what information do I need to have available?
Before you call, it is a good idea to contact your physician's office to get the best description possible of the services that you need. Then, if you have insurance, contact your insurance company and make sure that the services required are covered services under your specific plan. If they are not covered, then you would be considered uninsured for these services.
When you call us, please try to have the following information at hand so that we can provide you with our best estimate of your financial responsibility:
Description of services needed - we will need to know as much information as possible about the specific services needed as described by your physician.
Type of services needed - we need to know if you will be admitted to the hospital as an inpatient overnight, or if you are expected to be treated on an outpatient basis.
Physician/specialist name – for example, if you are having surgery, we will want to know the surgeon's name.
If you have insurance, we will need:
Your insurance card - please have your card available so that, if needed, we can get the following information from you: name of insurance company, type of policy (e.g. HMO, PPO, POS, indemnity), policy holder's name, group name and number, policy number, insurance company phone number.
Policy holder's personal information - it is possible that the insurance company will want us to verify the Social Security number and date of birth of the person who is named as the primary insurance policy holder.
Can I get an exact pricing quote?
Unfortunately, no. We will do our best to provide you with a pricing range based on our hospital's historical pricing for comparable services. Price quotes are not guaranteed since the services used to compute the quote can vary from services you receive due to treatment decisions, unforeseen complications, additional tests or services ordered by your physician, and variation in the clinical needs of each patient.
What is expected of patients in terms of payment?
Similar to your visits to your physician's office, we expect payment at time of service. If you have insurance or other coverage, we will expect you to pay your copayment, coinsurance and/or deductible upon arrival at the hospital. After your insurance company pays us, we will send you information about any amount you may still owe.
If you are uninsured, we expect payment at time of service (or will work with you to arrange monthly payments) for the estimated price of your services. If any additional payment is due after your services are received, we will send you information about any amount you may still owe. If you receive emergency care and cannot pay for your services, with your cooperation our financial counselors will evaluate whether you qualify for local and state programs, including County Assistance and Medicaid, or our financial assistance program.
We accept major credit cards, checks, money orders and cash.
Do you have a charity policy?
We provide free hospital care for patients who have received non-elective care, who do not meet qualifications for Medicaid, and whose income is less than 300% of the Federal Poverty Level (in most cases). In order to qualify for this free care, you must complete a Financial Assistance Application and provide some documents to support your income. Read our Baptist Financial Assistance policy. For patients who do not meet the charity criteria and will be expected to pay for services out of pocket, we offer a discount similar to managed care. All uninsured patients (excluding those receiving cosmetic procedures and certain "package" procedures) will be given an uninsured discount.
What do I need to do if I need help paying my bill?
Baptist Health Care provides many ways for you to financially manage your health care:
Filing your insurance
Payment methods of cash, credit or check payable before service during the preregistration process, at registration, or through online payment options.
If you are insured, a claim will be sent to your insurance company. After they receive the claim, the insurance company may contact you for additional information. Please respond to your insurance company's questions as quickly as possible so their payment is not delayed. It usually takes 14 to 45 days for your insurance company to pay your claim. After they pay us, we will provide you with information about any amount you may owe that you did not already pay upon arrival at our facility. Please keep in mind that your policy is a binder between you and your insurance company. If you did not follow your insurance plan's terms, they may not pay for all or part of your care.
When should I expect to receive my hospital bill?
If you have no insurance or did not present insurance at the time of your service, you should receive your hospital bill with seven days after discharge or date of outpatient service. If you provided your insurance information when you registered, you will not receive a bill until:
Your insurance company denies the claim
Your insurance company pays the claim, leaving a coinsurance, deductible or a fee for non-covered services
Your insurance company hasn't responded to the claims
What information will be included in my bill?
Your bill will contain a summarized list of the supplies, drugs, tests and procedures provided to you by Baptist Health Care. You should keep this for your records.
When do I become responsible for my bill?
You are legally responsible for your bill at the time you receive services from the hospital. Patient balances should be paid immediately after you are notified. If you are unable to pay in full, please contact our Customer Service at 850.908.2000 to set up payment arrangements.
What if I get more than one bill?
You may receive more than one bill for the same hospital stay. These bills are for services provided by physicians, anesthesiologists, radiologists or other health care professionals. If you have any questions about a specific bill, please call 850.908.2000.
You can pay cash, check, money order or credit card in person at your physician’s office.
You can pay check or money order by mailing this payment method to us. Make the check or money order payable to the Baptist Health Care and include your account number.
You can pay your balance by credit card over the phone, make payment arrangements, ask additional questions or resolve account issues by calling a customer service at 850.908.2000.
Any bills you receive from physicians not employed by Baptist Health Care can be paid by contacting those providers directly.
Which bill can I pay online?
Currently, online bill payment is available for services rendered at any Baptist Healthcare location. This includes X-rays, inpatient services and other medical care the hospital provided. Please note that some services rendered at our facilities may result in a physician bill that cannot be paid using our billing system. Such services may include, but are not limited to, radiology, pathology and emergency department visits; these services need to be paid to the source that billed you.
Should I bring my insurance card with me to the hospital?
Yes, the information on your insurance card is needed for the hospital to file a claim with your insurance company or companies. When you register we will ask for information about your insurance coverage and have you sign a few forms. This registration process goes much faster when you bring your insurance information with you.
Do I need to let my insurance company know that I'm going to be in the hospital? What will they cover?
We encourage you to check with your insurance company or your employer about this. Because there are so many types of insurance plans, it is difficult for us to tell you whether or not you need prior approval or notification for your hospital stay. Contact your insurance company or your employer with specific questions about what is or is not covered by your insurance plan.
How do I know if my insurance company will cover my visit or certain services?
Coverage varies with each insurance company. Generally, the hospital staff does not know whether a particular service will be covered. Medically necessary and appropriate services may not always be covered by your insurance contract. Please refer to your insurance member handbook or call your insurance company with questions.
How do I know if my insurance company will cover services provided by all professionals (i.e. anesthesiologists, radiologists and pathologists) involved with my treatment?
We encourage you to check with your insurance company or your employer about this. Each professional needs to contract individually with insurance companies and the hospital does not know if each professional is contracted with your insurance company.
Will you bill my insurance company for me?
Yes, as a courtesy we will bill your insurance company. It is your responsibility to provide any requested information to your insurance company (accident information, claim forms).
How will I know if my insurance company has paid my bill?
If there is a balance due from you after the insurance company has paid its portion, we will send you a statement. This statement indicates the amount that has been paid and any balance you are required to pay. This is your bill. You are required to pay this bill in full or you will need to contact our office.
How do I follow up with my insurance company?
Before you call, make sure you have your insurance card, date of service, facility name, original billed amount, patient name and claim number, if applicable. Obtain satisfactory status of account. If paid, ask when and to whom. Note this information and with whom you spoke to at the insurance company. If the bill has not been paid, find out when the anticipated payment date is and ask if they need anything from you. If the bill is not paid in the stated timeframe, follow up with the insurance company again and, if necessary, request to speak to a supervisor.
What do I do if I disagree with how much my insurance company has paid on my bill?
If you disagree with the insurance company's payment amount, contact the insurance company and ask them to review how the claim was processed. If the insurance company finds that an error was made, note the information and whom you talked to at the insurance company. Request an anticipated payment date and ask if they need anything from you. If the insurance company feels the bill was paid correctly and you still disagree, find out from the insurance company what you need to do to file an "appeal" with them. Filing an appeal will not guarantee that the insurance company will pay more on your bill, but the claim will be reviewed for reconsideration.
Will I be required to pay anything when I arrive at the hospital?
Upon admission, you will be required to pay the difference, if any, between your verified insurance benefits and the estimated charges for your stay. This amount is based on the average of actual daily hospital charges for patients admitted with similar diagnoses, multiplied by the number of days you are expected to be in the hospital. Your actual charges may be more or less than the estimate. If they are less, you will receive a refund. The deposit does not include your physician's charges or those of other consulting physicians. Those costs will be billed to you directly, once you have returned home.
Does Baptist provide free care for patients without insurance?
Baptist Health Care is a state and federally funded hospital. Baptist Health Care does provide an assistance program for those who qualify. Our physician practices require some type of payment at the time of the service. Most departments will work with patients to reach an agreement as to the amount that is owed per each visit. For specific information, please contact a financial representative in the physician office in which you wish to be seen.
Does Baptist accept my insurance?
Insurance acceptance varies from physician to physician in our outpatient practices. To find out if a specific physician will accept your insurance, you may contact the Baptist Health Care Business Office at 850.908.2000. A service representative will be happy to assist you.
How much will Medicare or Medicaid pay?
Medicare and Medicaid will pay for hospital services. You will be responsible for the copayment. If you belong to a Medicaid Managed Care Plan or if you signed over your Medicare benefits to a managed care plan, you may need an authorization to see a Baptist physician or receive hospital services. Visit our insurance information online to find out more specific information.
Why do I have to give you information about other insurance if I have Medicare coverage?
Medicare requires us to bill any insurance company that could have responsibility for your expenses before we bill Medicare. In fact, Medicare will not allow us to file claims until the other insurer has denied claims. In certain situations, the hospital must consider the possibility that another party may be responsible for your expenses before we bill Medicare. For example, if you were injured in a car accident, at your work site or on someone else's property, it is the hospital's responsibility to make sure those claims are filed appropriately. Consequently, we need to have complete information about all insurance coverage you have.
Do I have to sign any forms before Baptist can bill Medicare?
You will be asked to sign a Consent for Treatment form each time you receive services. You will also be asked questions each time you receive services that Medicare requires we ask.
I have health insurance in addition to Medicare coverage. Will you bill that insurance company also?
If you have given us information about your additional health insurance, we will bill that insurance company after Medicare makes their payment.
What is the Medicare Explanation of Benefits form?
The Explanation of Benefits form is an information document that Medicare sends to you after it has processed your medical claims. The Explanation of Benefits form provides you with information about the payment status of your bill.
What is the difference between Part A and Part B Explanation of Benefits forms?
Part A covers inpatient hospitalization and Part B covers outpatient and physician services.
What should I do with the Explanation of Benefits forms?
We recommend you keep the Explanation of Benefits forms you receive from Medicare until all your medical claims have been paid in full. If you have other health insurance in addition to Medicare coverage, your insurance company will normally require a copy of the Explanation of Benefits from you before they will pay any remaining balance on your account.
Should I pay the balance that is listed as "your total responsibility" on the Explanation of Benefits form?
No. This amount could change depending on your individual insurance coverage. You should wait until you receive a bill from your medical provider before making payment.
Will I have to pay any money for my hospital visits?
As a Medicare patient, you will only be responsible for non-covered charges, copays and deductible amounts. These amounts may vary depending on your Medicare coverage. We do not know what your payment may be until we receive the notification from Medicare. Once Medicare lets us know your responsibility, we will bill your other health insurance company (if you have coverage) for the balance. If you do not have other health insurance, you will be billed for the balance.
How can I request my medical records from Baptist Health Care?
I was born in a different state, can I get a copy of my birth certificate from Baptist Health Care?
Baptist Health Care does not provide birth certificate copies. Patients needing copies of their certificates of birth will need to contact the Escambia County Health Department by phone 850.595.6531. You can also mail your request to:
Escambia County Health Department
Department of Vital Statistics
1295 W. Fairfield Drive
Pensacola, FL 32501