Billing & Insurance Requirements
Thank you for choosing Richmond University Medical Center for your medical care. Richmond University Medical Center (“RUMC” or “the hospital”) participates or is contracted with most commercial and managed care carriers, and the Medicare and Medicaid fee for service and managed care programs. RUMC will bill your insurance carrier directly if complete billing information has been provided and the required approvals have been received. We will attempt to collect this information at the earliest possible point in your care experience with us, to assure that there are no delays in providing your care.
Your insurance plan benefits represent a contract between you, your insurance company, and your employer if you have an employer sponsored health plan. Insurance benefits coverage is complicated, varies among different insurance companies, and can change from year to year even with the same insurer and employer. To take advantage of the benefits available to you, and to limit your out of pocket financial obligations, you should familiarize yourself with the terms of your insurance coverage for you and any covered family members, including required approvals (pre-authorizations) prior to receiving hospital care, physician and/or hospital deductible amounts, co-pay amounts for hospitals and physicians, and coinsurance financial requirements for certain types of services or providers. Some plans may require that you notify them of Emergency Department services within 24 hours of treatment.
If RUMC does not participate with your insurance carrier, you may be responsible for a greater portion of your hospital bill. If RUMC does not receive approval from your insurance company for your care (e.g., a non-covered service, experimental or clinical trials not approved by your insurer, or medical devices not approved by your insurer), you may be responsible to pay for the cost of your hospital care. If you have any concerns about coverage of the care you are scheduled to receive, please contact your insurance carrier and request written authorization for your hospital services.
In addition to a hospital invoice from RUMC, you may receive bills from other providers or physicians:
- Physicians who were asked to participate in your care by your primary care physician, such as orthopedic surgeons, allergy and infectious disease consultants
- Physician Assistants or Hospitalists who managed your daily care in the hospital
- Anesthesiologist who assisted during a hospital procedure with your local or general sedation
- Physicians who interpreted imaging or laboratory tests to help diagnose and treat you
It is the hospital’s obligation to collect any patient financial obligations, such as co-payments or deductibles, that are consistent with your insurance benefit plan. RUMC Financial Counselors are available to assist or guide you on questions concerning you financial responsibilities or to interpret your bills for medical care before, during or after your admission, test, or procedure; and can be reached at 718-818-2330.
Self-pay (uninsured) and under-insured patients will have the opportunity, if eligible, to apply for Medicaid or to be granted a reduced fee based on the guidelines in the hospital’s Financial Assistance Program. The Medicaid application and financial assistance staff can be contacted at 718-818-2289. Please contact these professionals at the earliest opportunity if you have any questions about your coverage, or are concerned about your obligation for your hospital bill or your ability to pay.