Services

Patient Financial Services

The Patient Financial Services staff is available to respond to inquiries by phone regarding billing.

Via the phone, patients may request an itemized statement, pay their amount due with a checking account or credit card, set up a payment plan, and/or provide additional insurance information not given at the time of service.

In addition, our staff can provide some information related to the patient's insurance benefits and exclusions.

Q. What is the difference between a co-payment, co-insurance and deductible?

A. In most cases, health insurance carriers offer two major types of coverage; HMO plans or traditional plans. HMO plans generally set a fixed dollar amount for office visits, outpatient visits, emergency room visits and sometimes inpatient stays that the patient is required to pay directly to the provider at the time of service. This is called a co-payment.

Traditional plans and Medicare establish a fixed dollar amount that must be paid by the patient (usually annually) prior to any payment made by the health insurance carrier. This is called a deductible.

A co-insurance is typical with traditional plans and Medicare. The health insurance carrier pays a percentage of the charge and the remaining balance is the responsibility of the patient.

Q. Why was my health insurance carrier not billed?

A. There are times when Kaleida Health does not have adequate insurance information to generate a bill to the insurance carrier. In these cases, we have no alternative but to send a patient statement to the patient’s guarantor requesting additional information. When you register for medical services, it is very important that you provide all of the necessary information so that we are able to bill your insurance carrier for payment.

Q. What information is needed to bill my insurance carrier?

A. The following information is required:

• The name, address and phone number of your insurance carrier.
• The subscriber’s name on the policy.
• The identification number including any prefix and/or suffix.
• The effective date of the policy.

It is very helpful if you show the registration clerk or receptionist your health insurance identification card each time you come in for medical services. You may ask to have this information read back to you to ensure your record is accurate.

Q. Why did it take so long for me to receive a bill?

A. It is a practice of Kaleida Health not to bill a patient until we have exhausted all means of obtaining payment from your health insurance carrier. At times, we receive partial payments or denials that we feel are incorrect. Therefore, we must follow the appeal process established by your health insurance carrier to dispute their decision. These processes can result in a delay in billing you for your portion of the bill.

Q. How can I obtain a detailed or itemized statement?

A. Simply call our customer service department at 859-7200 Monday through Friday between the hours of 8:30 am and 4:30 pm and our representatives will be happy to mail you one.

Q. Can I pay my co-payment or balance by credit card?

A. All of the Kaleida Health sites accept Visa, MasterCard, American Express and Discover. You may charge any payment utilizing one of these credit cards. We can also take this information over the phone if it is inconvenient for you to come to a cashier window in person, or you can pay online.