We know that while you are sick or injured, the last thing you want to think about is your hospital bill. That’s why we’ve compiled a simple list of information regarding billing and insurance.
Understanding the Emergency Room Facility Fee
When patients need emergency care, hospitals charge a facility fee to pay for patient's care. Facility fees are based on how much care the patient needs on a scale from one to five. Click here for more information.
If You Have Health Insurance
We will need a copy of your identification card. We also may need the insurance forms that are supplied by your employer or the insurance company. You will be asked to assign benefits from the insurance company directly to the hospital. For a free pdf of a consumer guide to help you understand healthcare and insurance pricing, click here.
If You Are a Member of an HMO or PPO
Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests, procedures, or hospital stay. It is your responsibility to make sure the requirements of your plan have been met. If your plan's requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your healthcare plan and their services may not be covered.
If You Are Covered by Medicare
We will need a copy of your Medicare card to verify eligibility and process your 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, personal comfort items, hearing evaluations and others. Deductibles and co-payments are also the responsibility of the patient. These payments are due at the time of your discharge.
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. Co-payments are the responsibility of the patient and are due at discharge.
If You Have No Insurance
If you do not have health insurance, your representative will assist you with financial arrangements including applying for financial aid (CICP). Presently, there is a program available, which can help qualifying patients with part of their hospital bill. For more information, contact the Business Office at 719-587-6364. The Self-Pay Discount (20%) is automatically applied when the charges are applied to uninsured account balances. Patients who are able to pay in full for their services within 30 days of billing may be eligible for a 40% prompt-pay discount. To view some costs for common procedures, click here. To view the chargemaster, click here.
Your Hospital Bill
The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital bill. The American Hospital Association distributed this consumer guide to avoid surprise bills.
Your bill reflects all of the services you receive during your stay. Charges fall into two categories: a basic daily rate, which includes your room, meals, nursing care, housekeeping, telephone and television; and charges for special services, which include items your physician orders for you such as x-rays or laboratory tests.
If you have certain tests or treatments in the hospital, you may receive bills from physicians you did not see in person. These bills are for professional services rendered by doctors diagnosing and interpreting test results while you were a patient. If you have questions about these bills, please call the number printed on the statement you receive from them.
We welcome your feedback
If you would like to share your patient experience or expectations or feel you haven't been heard or that your questions were not addressed at San Luis Valley Health, you may email, call or file a grievance by using our email link: email@example.com, or call our Patient & Visitor Grievance Line: 719-587-5702.