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Sometimes billing and insurance information can be confusing. We've compiled a helpful list of answers to frequently asked questions. Should you have questions about your bill that can't be answered here, please contact our billing department at 814-362-8570, Monday-Friday 8:00 a.m. - 4:00 p.m. We have a well-trained staff to file your claims and to answer any questions you may have about your hospital bills.
What do these terms mean?
ABN- (Advanced Beneficiary Notice) a waiver by patient when there is reason to believe that the service will not be paid by Medicare.
APC- (Ambulatory Payment Classification) an outpatient reimbursement methodology that groups procedures into like categories and assigns a payment rate to each category.
Co-pay- Amount to be paid by patient (or secondary insurance, if applicable) estimated by the insurance company. It varies based on type of service.
Cross-Over- For certain secondary insurances, Medicare will send the claim directly to the other insurance and the hospital will not need to send anything.
DRG- (Diagnostic Related Groupers) inpatient reimbursement methodology that groups inpatient conditions into like categories and assign a rate to each category.
EOB- (Explanation of Benefits) notification from your insurance company what was paid to the doctor or hospital.
Medicare HMO- Patients have the option to have another insurance company pay for their medical bills in place of Medicare. Examples: Independent Health Encompass 65; Univera Senior Choice.
MSP- (Medicare Secondary Payor) doctors and hospitals are required to ask patient specific questions to determine if the patient may be covered by a health plan other than Medicare. Medicare is not always the primary payor.
Pre-authorization- For certain tests, insurance companies require doctors to obtain permission from them before the test can be ordered.
Why do I have to show my insurance cards every time I come to the hospital?
To better serve our patients, we like to make sure that we have accurate and up-to-date information on file. Sources other than the patient (i.e. your doctor's office) may provide inaccurate data that may cause delays in payment and cause frustration for you and for us.
Do I have Medicare or a Medicare HMO?
|If your card looks like this, you have Medicare|
|If your card looks like this, you have
a Medicare HMO
(You do NOT have Medicare)
Medicare Questions : (716) 375-7454
Bradford Regional Medical Center recognizes that there are times when patients in need of care will have difficulty paying for the services provided. Bradford Regional Medical Center’s financial assistance program provides discounts to qualifying individuals based on income. In addition, we can help you apply for free or low-cost insurance, if you qualify. Just contact our Patient Financial Liaison at (814) 362-8588 for free, confidential assistance. Click Here for the Financial Assistance Policy