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The Richland Hospital and Clinics is happy to help you better understand insurance coverage. If you have health insurance, we will bill your insurance company on your behalf. At times, The Richland Hospital and Clinics or your insurer may need additional information to process your claims. Please be sure to respond promptly to any requests for more information.

You may still owe a balance after your insurance plan pays your claim. Your insurance plan may require multiple deductibles, copays, and/or coinsurance. Coverage will depend on the type of plan you have chosen.

If your insurance provider does not make payment(s) promptly or does not respond to our attempts to resolve payment matters, we will send you a bill. Be sure you know your health insurance policy and all pre-certification and pre-authorization requirements. If your health insurance denies your claim, you will be responsible for contacting them for resolution or you may be responsible for the charges.

Network Status

The Richland Hospital and Clinics participates in a variety of health plans. You can learn the details of your policy by visiting your insurance company’s website or contacting its customer/member services department. The back of your insurance card should include the phone number and website address you will need.

Questions to Ask Your Insurer

  • Is the Richland Hospital and Clinics in-network for my plan? If not, how will this affect payment for the services I would receive?
  • Is my hospital service covered completely? If not, how much will I be expected to pay?
  • Will tests be covered completely if I need tests? If not, how much will I be expected to pay?
  • If I need a procedure, including surgery, how much will my insurance cover? How much will I be expected to pay?
  • Will I need authorization before my healthcare visit?

In-Network Status

The Richland Hospital and Clinics is in-network with many insurance plans and is continuously working with various plans to become part of their network. Please contact your plan as noted above to determine your network status.

Out-Of-Network Status

If your health insurance plan is out-of-network, you may still be seen by a provider of The Richland Hospital and Clinics. However, you may experience higher out-of-pocket costs than if you are seen by a Network Provider, or your services may not be covered. Please contact your plan as noted above to determine your network status.

INSURANCE TERMINOLOGY

  • Coinsurance: a term in a policy, where the insured person and the insurer share the covered charges under a policy in a stated ratio. For example: A certain medical procedure is covered 80 percent by the insurance company and 20 percent by the insured.
  • Co-pay: a small fixed amount required by a health insurance company to be paid by the insured for each outpatient visit or drug prescription. For example: Your doctor prescribed a test that costs $50. The copay assigned by your health insurance company is $20. You will pay $20 and the insurer will pay the remaining $30 for the $50 prescription.
  • Deductible: the amount for which the insured is responsible for on each loss, injury, etc, until satisfied, before an insurance company will make payment: For example: The deductible on his medical coverage has been raised from $2000 to $5000 per family per year.
  • Premium: the amount paid by a policyholder to keep an insurance policy in force, usually monthly. Sometimes the premium is paid for by the insured’s employer, or a portion is paid by the employer and a portion is paid by the insured.
  • Policy: the legal document issued by an insurance company to a policyholder, which outlines the conditions and terms of the insurance.