How to Read Your

Tips for understanding different types of hospital bills, insurance benefits and out-of- pocket costs.

There are three different types of hospital bills that you might receive: summary bill, itemized bill and billing statement.

In addition to your hospital bill, you may receive separate bills from your physician(s): emergency physicians (care provided in the emergency department), radiologists (imaging services), consulting physicians (other physicians brought in by your physician), pathologists (laboratory and pathlogy tests), anesthesiologists (surgical procedures) and surgeons.

If you have questions or concerns regarding a bill or statement you have received, contact the hospital’s patient billing office. Use Find a Provider to access the main phone number, address and website for MHA hospital members. Never avoid your bill or your account will fall into delinquency and can result in a referral to a collection agency.

Explanation of Benefits (EOB), or a statement from your health insurance, identifies the amount you owe for your hospital visit or outpatient procedure and what benefits were paid by your insurance on your behalf.

Out-of-Pocket Costs or “patient responsibilities” are the amount you owe for the hospital visit or outpatient procedure. If you are insured, patient responsibilities are outlined in your health insurance policy and typically include a deductible, coinsurance and/or copayment. Many hospitals request that the patient responsibility be paid upon discharge. If you are unable to pay at that time, you should inform the hospital’s patient billing office to make payment arrangements. Note that the unpaid balance might be subject to interest payments.

If you have two insurance policies providing hospital coverage, the primary plan must pay or provide its benefits as if the secondary plan(s) did not exist. A plan may consider the benefits paid or provided by another plan only when it is secondary to that other plan.