HMOs

Bon Secours will bill contracting HMOs for inpatient and outpatient charges. Any bill not acknowledged by the HMO after 40 days is considered your responsibility. Bills must be paid within 30 days from the date the notice is sent.

Inpatients/Outpatients
Co-payments are due at the time of admission or outpatient registration. Payments for applicable coinsurance, deductibles and any non-convered services are due within 30 days after the insurance payment, but no later than 75 days from the bill date.

You may deduct 10% of the patient portion of this bill if you pay within 30 days of the bill date. Please note that you are responsible for deducting the prompt pay discount at the time of payment. If you are unsure of the discount amount, please call our customer service line. If you do not deduct the 10% prompt pay discount at the time of payment, no credit or deduction will be made.

Your Insurance Claims

• You are responsible for providing insurance information at the time of admission or outpatient registration.
• Contact your insurance company if payment has not been made within 45 days.
• You should receive an Explanation of Benefits (EOB) from your insurance company stating how much the insurance company paid and how much you owe. Contact your insurance company if you do not receive an EOB within six weeks from the date of service.

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

Commercial Insurance/PPO

Bon Secours will bill approved insurance companies for inpatient and outpatient charges. Bills not paid after 45 days become your responsibility and must be paid within 30 days from the date the notice is sent.

Inpatients/Outpatients
Co-payments are due at the time of admission or outpatient registration. Payments for applicable coinsurance, deductibles and any non-convered services are due within 30 days after the insurance payment, but no later than 75 days from the bill date.

You may deduct 10% of the patient portion of this bill if you pay within 30 days of the bill date. Please note that you are responsible for deducting the prompt pay discount at the time of payment. If you are unsure of the discount amount, please call our customer service line. If you do not deduct the 10% prompt pay discount at the time of payment, no credit or deduction will be made.

Your Insurance Claims

• You are responsible for providing insurance information at the time of admission or outpatient registration.
• Contact your insurance company if payment has not been made within 45 days.
• You should receive an Explanation of Benefits (EOB) from your insurance company stating how much the insurance company paid and how much you owe. Contact your insurance company if you do not receive an EOB within six weeks from the date of service.

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

Uninsured

Bon Secours responds to community health needs by providing the highest quality of care. At the same time, we recognize the cost of health care can be a significant, unexpected expense for our customers. To help offset these costs to our uninsured patients and their families, we are providing a Community Service Adjustment to reduce your account balance.

Effective September 1, 2004 all patients who are uninsured will receive a Community Service Adjustment to their hospital bill.

Please call our Customer Service Center at one the numbers listed below. One of our Customer Service Representatives will explain our payment options including Bon Secours Financial Assistance Program.

(Cosmetic procedures excluded)

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

Medicare

Bon Secours bills the federal Medicare program and supplemental insurance companies for inpatient and outpatient charges. You are responsible for charges not covered by Medicare.

Inpatients/Outpatients
Bon Secours will bill Medicare supplemental insurance plans for inpatient and outpatient charges.

Payment for all applicable coinsurance, deductibles and non-covered charges by patients who are not covered by supplemental insurance are due 30 days from the date the notice is sent.

You may deduct 10% of the patient portion of this bill if you pay within 30 days of the bill date. Please note that you are responsible for deducting the prompt pay discount at the time of payment. If you are unsure of the discount amount, please call our customer service line. If you do not deduct the 10% prompt pay discount at the time of payment, no credit or deduction will be made.

Your Insurance Claims

• You are responsible for providing insurance information at the time of admission or outpatient registration.
• Contact your insurance company if payment has not been made within 45 days.
• You should receive an Explanation of Benefits (EOB) from your insurance company stating how much the insurance company paid and how much you owe. Contact your insurance company if you do not receive an EOB within six weeks from the date of service.

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

Third Party Liability

Bon Secours will bill third party liability insurance (auto, homeowners, etc.) for inpatient and outpatient charges.

You may deduct 10% of the patient portion of this bill if you pay within 30 days of the bill date. Please note that you are responsible for deducting the prompt pay discount at the time of payment. If you are unsure of the discount amount, please call our customer service line. If you do not deduct the 10% prompt pay discount at the time of payment, no credit or deduction will be made.

Please be aware
When liability is disputed, it is your responsibility to resolve the dispute with the third party. Bon Secours will file your insurance claim; however, you are responsible for payment.

Litigation Accounts
When attorneys are involved in a third party dispute, Bon Secours will hold the account if

• the account balance is over $1,000;
• you are financially unable or;
• your attorney provides a letter signed by you and your spouse that guarantees a lien against the settlements and immediate payment to Bon Secours from the settlement monies.

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

Workers' Compensation

Bon Secours will bill authorized insurance companies for workers' compensation claims.

You are responsible for providing information relating to your workers' compensation insurance at the time of admission or outpatient registration. You should contact your employer if payment has not been made within 45 days.

Please Be Aware
Your employer should accept liability for the workers' compensation claim prior to admission or outpatient registration.

Your Insurance Claims Patients must provide:

• claim number
• claim representative's telephone number
• workers' compensation insurance company name
• employer's name, address and telephone number

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.

State Requirements

The Bureau of Insurance of the Commonwealth of Virginia requires insurance companies to pay claims within 15 days of receipt and HMOs to pay claims within 30 days of receipt, or they are to pay interest.

You have the right to contact the Insurance Commissioner's Office of Consumer Affairs (804-371-9691) if you believe your insurance company or HMO is not processing your claims within 45 days.

You can contact the Customer Service Center at 804-342-1500 or toll free at 877-342-1500 for more information.