Here is an overview of the different types of bills you can expect to receive, depending on the services provided to you.
Inpatient BillsPatients who are admitted to the hospital (inpatients) will receive multiple bills. One bill will be from the hospital. This bill includes charges for your room, medical supplies and services, and any tests or procedures that you may undergo, including X-rays. You also will receive separate bills from Apogee Physicians and other non-employed physicians that provided services to you during your stay.
Obstetrics/Newborn BillsExpectant parents have a decision to make related to insurance coverage for the child. If both parents have insurance through their employer, we recommend contacting each employer’s Human Resources department to inquire on the process for adding a dependent to your insurance plan. You should complete your insurance discussions prior to your expected delivery date to identify the most cost effective option for you.
Upon delivery, you need to contact your Human Resources department and request to add coverage for your new child. If you have coverage through Medicaid, you will want to notify your care manager. This ensures that the newborn will be added to your insurance as a covered dependent.
Once you have determined which plan your child will be added to, please contact our Billing Support department at 877-744-7081.
Your preparation and attention in advance will help prevent insurance denials.
Also, in preparation for your delivery, and as anesthesia is typically used in deliveries, please refer to the Before Your Visit: Anesthesia Services section.
You will receive a bill from the hospital, the OB-GYN physician involved in the delivery and Bay Anesthesia. You will also receive a separate bill from the hospital for the baby and one from the pediatrician for your new child.
Observation BillsPatients who require observation are placed in a normal inpatient setting; however, they have not been formally admitted by a physician, as they don’t meet clinical criteria for an inpatient stay. These patients are typically in the hospital one or two nights, while the physician is waiting for test results to determine treatment plans. If the patient’s condition does not meet inpatient criteria, they will be discharged.
If you’re placed in observation, your insurance company pays the hospital under the outpatient provisions of your benefits, and you will receive bills from Bayhealth Observation Physicians and/or any non-employed physicians who provided care to you. It’s important to remember Bayhealth has an obligation to place you in the correct level of care (observation or inpatient) based on your clinical condition and the medical criteria you meet.
Surgery BillsPatients who require surgery will have multiple bills. One bill will be from the hospital. This bill includes charges for the operating room, surgical supplies and services, and any pre-surgery tests or procedures that you may undergo, including X-rays. An additional bill will come from Bay Anesthesia. Bay Anesthesia is out of network for some insurance plans. Patients should call their insurance company prior to having surgery to determine if Bay Anesthesia is in or out of network. You will also be billed for the physician performing the surgery.
Emergency Department BillsPatients seen in an emergency setting will receive multiple bills. Your emergency bill may include charges for your visit as well as any tests or procedures that are done at the time of your visit. You will be billed separately for services provided by the Emergency Department (ED) physician. These bills will come from Bayhealth Emergency Physicians. It is important to note that bills for Bayhealth Emergency Physicians are sent separately from Bayhealth Hospital bills. The Bayhealth Emergency Physician billing phone number is also separate, 1-855-691-9890.
Recheck visits to the ED may result in additional charges if new symptoms are presented for evaluation.
Obstetrical Emergency Department (OBED) BillsPatients seen in the OBED will receive multiple bills. One bill will be from the hospital for the OBED visit and another will be from the OB Hospitalist (physician) who treated you in the OBED.
Imaging BillsImaging involves X-ray, ultrasound, CAT scan (CT), MRI, MRA, nuclear medicine, and PET. You will receive two bills for Imaging services; one from Bayhealth and one from Kent Diagnostic Radiology (KDR) for the professional interpretation of the scan.
Doctors' BillsThe bill from your doctor(s) will include the cost of medical and surgical care they provide, including review and interpretation of your diagnostic tests. You may receive multiple bills if more than one physician is involved in your case. Most doctors are independent practitioners and will bill you for their services (i.e., reading X-rays, inpatient physician coverage, consult visits, etc.) Bayhealth does employ doctors for pathology, oncology, neurosurgery, maternal fetal medicine, observation, emergency department, and clinics. If Bayhealth employs the doctors, we’ll bill insurance or you for their services either under the name of Bayhealth Medical Center or Bayhealth Physicians.
Provider Based Practices
Anticoagulation/Pharmacy Clinic, Cardiac Diagnostic Center, Maternal Fetal Medicine, Oncology, and the Pharmacy ClinicBayhealth has several provider based physician group practices whereby the provider service location is considered a department of the hospital. These practice locations outside of the hospital have signs posted advising patients they are receiving care in a provider based location. This is important for patients to know for the following three reasons:
- As a patient, you may be required to pay a coinsurance for services provided at this facility for diagnostics such as lab or X-ray tests or treatments such as physical, occupational or speech therapy.
- Unlike a private office setting, you may also receive a second bill for co-insurance for physician services related to this visit. For example, you might receive a bill from the radiologist or pathologist who reviewed your diagnostic test.
- In summary, you may incur a coinsurance liability to the hospital that you would not incur if the facility were not provider based. At the same time, coinsurance amounts should be consistent with those that would be charged for the same services provided on the hospital campus.
Help Us Get Your Claims PaidMany commercial insurance plans request that their subscribers update their insurance information on an annual basis. Your insurance company or employer’s Human Resources department will mail you a letter asking you to fill out a coordination of benefits form and return it. Completion of this form is critical to having your claims paid, as your insurance company will deny the claim or pay it at a significantly lower rate, leaving you with a high patient responsibility amount. If the forms are not returned, Bayhealth will hold the patient responsible for the balance due.
In addition to coordination of benefits information, your insurance may also mail you a letter requesting accident details, student or other information. Please be sure to open mail you receive from your insurance company and respond as timely as possible since completion of their information requests creates a more positive billing experience.