After a visit to the hospital, it can be confusing to figure out who is billing you and what services are eligible for charity care, especially if insurance is involved. Learn more about medical bills and the different billing processes.
Who sends the bill?
Bills directly from the hospital (Dollar For can help!)
A hospital will nearly always send you a bill after a visit. This bill can include facility fees, lab tests, nursing services, and sometimes (but not always) the costs of the doctors who cared for you.
If your hospital has a financial assistance policy, this bill should be eligible under that policy. Dollar For can help you apply for financial assistance and try to get that bill waived.
Bills from doctors or others who treated you at the hospital (Dollar For can sometimes help.)
Doctors and others who work at hospitals sometimes bill patients separately. This often includes ER doctors, surgeons, anesthesiologists, radiologists, and pharmacies. These other providers will not automatically forgive your bills if you qualify for hospital charity care.
We recommend that you start by working with Dollar For to get charity care approval from the hospital. Then, we’ll instruct you to give copies of the approval letter to the doctors and other practitioners. They might adjust your bill to meet what the hospital offers you. For example, if the hospital forgave 100% of your bill, then they might too. If the hospital forgave 50%, then they may cut your bill in half to match that decision.
Bills from other medical practices, medications, or medical equipment (Dollar For cannot help.)
Unfortunately, the charity care rules only apply to hospitals. Dollar For is not able to help with these bills.
If you have other types of medical bills, contact Patients Rising. They are a free hotline that will connect you with resources for your situation.
You can also try:
- The Patient Advocate Foundation offers services to patients with diagnosed diseases.
- The Leukemia & Lymphoma Society offers financial assistance to blood cancer patients.
Who pays the bill?
If you already have health insurance
Hospitals will typically not consider charity care applications if they think your health insurance should pay your bill.
Here is what the process typically looks like if you have health insurance:
- When you visit the hospital, the billing office will collect your health insurance information. After your visit, the hospital will submit a claim to the insurance company listing all the services that they provided to you and asking insurance to pay.
- The insurance company will review the claim and decide what they are willing to pay. They will send that information to both the hospital and to you. You will receive something in the mail called an “Explanation of Benefits,” also called an “EOB.” This is not a bill.
- The hospital will review the EOB and then typically, they will send you a bill for the amount that your insurance did not pay. This is the best time to submit your financial assistance application. Depending on your hospital’s policy, they might waive the balance.
- However, if the hospital (or you) disagrees with the insurance, they might go back and forth for a while to try to get the insurance to pay more. During this time, the hospital is unlikely to approve your financial assistance application. They will typically want to wait until insurance has been settled. The best thing you can do is be persistent. Keep following up with both the hospital and the insurance company to urge them to find a resolution.
- If you still have a bill after the insurance is settled, make sure to remind the hospital that you have submitted a financial assistance application and ask them to complete their review.
If you do not have insurance
Hospitals want to find any way they can to get paid for treating you. Your hospital might require you to apply for Medicaid or other state-funded health insurance before they will consider your financial assistance application.
If your hospital requires this step, you should always do it. If your Medicaid application is approved, the bill might be paid by Medicaid. If your Medicaid application is denied, then the hospital is still required to waive your bill if you qualify for the financial assistance policy terms.
Dollar For cannot help you to apply for Medicaid but there are many resources in every state to help people apply. If your hospital does not direct you to a helpful resource, you can find one here: www.healthcare.gov.