Billing and Payment: Frequently Asked Questions

A. As a patient, it is in your best interest to know and understand your insurance plan benefits and your responsibility for any deductibles, co-insurance, or co-payment amounts prior to any visit. Not all services are covered in all insurance contracts. If your insurance plan does not cover a service or procedure, you may be liable for full payment of the bill.

To find out what your insurance plan covers and what your financial obligation may be, call the Customer Service or Member Services Department of your insurance company (the phone numbers are on your insurance card). Your employer's human resources department may also be a source of information and assistance.

It is important to understand your insurance plan#8217;s current benefit and coverage rules. Policies and coverage determinations may vary from year to year. Please be aware that our outpatient visits are billed as #8220;hospital based outpatient clinics#8221; and not private doctor office visits. Some insurance plans pay different benefit levels for each type of visit. You should also check that your insurance company lists both your physician and hospital as participating providers. It is possible that only the physician or the hospital participates with your insurance plan. If you have services provided by an out-of-network provider, you may be at risk for a greater out-of-pocket financial responsibility.

If you do not see your physician and/or hospital listed as contracted with your health plan or you have any other insurance questions or concerns, contact the University of Chicago#8217;s Office of Managed Care at (773) 834-4730 or see our website at http://www.uchospitals.edu/billing/managed-care.html for a list of contracted insurance plans.

Q. What financial assistance is available if I have difficulty paying my bill?

A. You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. Financial assistance includes discounts for services provided to University of Chicago patients who are uninsured or under insured. For more information, please contact the Hospital Financial Assistance Representative at 773-702-6664 or toll-free at 800-827-0125.

Q. What should I bring when I come for services or if my insurance changes?

A. Please have your current insurance card with you at all times, as well as a photo ID, such as a driver#8217;s license, military ID, or government-issued ID. You are responsible to notify us of your insurance and any changes to your insurance coverage.

Q. What if my insurance plan requires a referral and/or a prior authorization?

A. If your insurance company requires a referral and/or prior authorization, contact your primary care physician prior to seeing a specialist.

If your insurance company requires a referral and you do not have one, you will be responsible for full payment of your bill at the time of service, or you may not be seen for your scheduled appointment. If your specialist requires more visits or tests than your insurer approves or if the referral has expired, you must contact your primary care physician for another referral and/or prior authorization.

Q. Why are you asking for my deductible, co-insurance or co-payment at the time of my visit?

A. We ask that payments be made at the time of service so you won#8217;t be bothered with an invoice sent to your home after your visit. It also helps us reduce our costs and saves you the trouble of mailing a payment back to the University of Chicago edical Center.

Q. I was a patient at the University of Chicago. Why have I been sent two bills? What is included on each bill?

A. During the course of your visit to the University of Chicago, you may receive a variety of inpatient or outpatient services and treatment. You may receive more than one bill for each of these services or encounters. These are not duplicate bills.

One bill will be for services provided by the University of Chicago Medicine, the others for services provided by the physician(s) involved with your care. For inpatient care, most physician fees are billed by the University of Chicago Physicians Group. These may include physician fees not only from your primary physician, but also from consulting physicians, anesthesiologists, radiologists, pathologists, and others who performed services for you. The bill from the University of Chicago Medicine will include charges for the hospital room, nursing care, meals, supplies, medications, and other miscellaneous items. The University of Chicago Medicine bill may also include technical charges for X-rays and lab tests while the Physicians Group bill may include physician fees for interpreting those same tests.

For outpatient care, the University of Chicago Physicians Group bill will include physician fees associated with diagnostic testing and most outpatient procedures. The bill from the University of Chicago Medicine will include physician fees associated with an outpatient clinic visit and other non-physician charges related to the visit and the tests and equipment used at the University of Chicago medical center.

Q. I was sent two bills for my medical services. How do I tell them apart? Who do I contact if I have questions about either bill?

A. University of Chicago Physicians Group bills are blue and white.

The University of Chicago Physicians Group handles all inquiries related to physician charges. For questions about your physician bill, call (773) 702-1150.

Address correspondence to:

University of Chicago Physicians Group

75 Remittance Drive, Suite 1385

Chicago, IL 60675-1385

Bills from the University of Chicago Medicine are red and gray.

The University of Chicago Medicine's Billing Office handles all questions related to hospital charges. For questions about your hospital bill, call (773) 702-6664.

Send payment to:

The University of Chicago Medicine

15965 Collections Center Drive

Chicago, IL 60693-0159

Send written inquiries to:

The University of Chicago Medicine

Patient Financial Services

150 Harvester Drive, Ste 300

Burr Ridge, IL 60527-5965

Q. When can I expect to receive a bill? Why was I sent a statement when my insurance company is supposed to pay my bill?

A. For patients with health insurance, once your insurance company has been billed and has responded to us, we determine how much you may owe and bill you.

Payment will be due thirty (30) days after a bill is sent to you. If your insurance company does not pay within ninety (90) days of receiving a bill from the University of Chicago, you may receive a statement showing that your insurance company has not paid the bill.

Whether you have insurance coverage or not, you as the patient are ultimately responsible to make sure your bill is paid. If you receive a statement showing that your insurance company has not paid, it may be helpful for you to contact your insurance company to ask why payment has not been made.


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