Insurance and Medicare Covered Hospital Charges

Commercial Insurance Coverage: Commercial insurance like Blue Cross, Aetna, Prudential, Travelers, etc., pay according to the provisions of the particular policy under which the patient is covered. On most policies, the patient must first meet an annual deductible before the insurance starts paying. For commercial insurance information, the patient should refer to the specific insurance policy or contact the insurance agent.

Hillcrest will bill your insurance company for the hospital charges at monthly intervals during your treatment.  You will be notified if we are unable to submit claims to your insurance company on your behalf or if the claim is denied. If this is the case, you may be asked to supply our patient accounting office with corrected information so that we can re-file the claim, if appropriate. Otherwise, you will be expected to pay the bill.

If you have any questions, please contact:
Business Office • Hillcrest Baptist Medical Center
3000 Herring Avenue • Waco, Texas 76708
Tel. 254-202-5631 or 1-800-224-8222

Medicare Coverage: Patients covered by Medicare need to be aware that Medicare handles hospital benefits differently from doctor benefits.

The Hospital Bill is Separate from the Physician’s Bill
TOTAL COST FOR MEDICAL SERVICES= HOSPITAL FEES + PROFESSIONAL FEES
(Hospital fees are paid to the hospital; professional fees are paid to the provider of service)

The total cost for many medical services is comprised of multiple fees. Each fee is billed separately by the provider of the services. You may receive bills from your physician, radiologists, pathologists, anesthesiologists, and/or others. For example, if you undergo radiation therapy at Hillcrest, there are two (2) separate charges for your therapy. One charge is for hospital services, and the other is for Radiation Oncologist’s professional services.

Your hospital fees cover the cost of providing the technician, nursing care, equipment and supplies involved in your care at our facility.  Professional fees are for the supervision, interpretation and consultation with physicians and/or other professionals. These professionals are independent, and are not employees of the hospital, and therefore bill separately.

Hospitals must treat patients for whatever Medicare pays plus payments from the patient of the amount that Medicare determines to be the patient’s responsibility. The patient’s part includes an annual deductible for outpatient and inpatient services.  After the patient meets the deductible for outpatient services, Medicare pays 80% of the charge, and the patient is responsible for the other 20%.

Medicare pays directly to the hospital for hospital services. When Medicare pays the hospital, the patient receives from Medicare a form called an Explanation of Medicare Benefits. This itemizes exactly what Medicare paid to the hospital. The Explanation of Medicare Benefits is important because it enables the patient to keep track of payments. For those with a commercial policy for coverage secondary to Medicare, a copy of the Explanation of Medicare Benefits is required by the commercial insurance company before it will pay its part of a Medicare-covered service.

As a Medicare provider, Hillcrest will bill your Medicare for hospital charges at monthly intervals during your treatment. Once Medicare has paid, if a balance remains, Hillcrest will also file any supplemental coverage for which you have provided information. If you have any questions about this portion of the bill, please contact:
Business Office • Hillcrest Baptist Medical Center
3000 Herring Avenue • Waco, Texas 76708
Tel. 254-202-5631 or 1-800-224-8222