Frequently Asked Questions about Billing
Will I know the cost of my hospital care before I receive the services?
It is important to confirm the extent of your coverage prior to admission to the hospital, as you will be financially responsible for any amount not paid by your insurance. For certain procedures and treatments, when no insurance coverage is involved, Cedars-Sinai does offer flat-rate cash packages. In some instances, there are too many variables to offer a detailed accounting of costs before your hospital stay, but we can provide a liability estimate. For those with insurance coverage, each benefit package is unique. So if we have not already provided you with an estimate, we encourage you to review your benefits and discuss your coverage with your health plan, Medicare or Medi-Cal before admission.
How does the billing process work once I have received services?
As a convenience to our patients, Cedars-Sinai Medical Center will first bill your insurance company directly for all services provided to you by the hospital. In most situations, your insurance carrier will pay the claim within 45 days of submission. The amount they pay will be based upon the plan benefits, as described in your health plan. If your insurer does not pay within this time, we may ask your assistance in prompting their payment.
Please note: Physician charges are not included in your Cedars-Sinai bill. You will be billed separately by any hospital-based physicians (radiologists, anesthesiologists, pathologists, etc.) who participated in your treatment.
Will I receive a bill?
If your coverage is through Medi-Cal, an HMO or Medicare HMO, you may not receive a bill. If your claim is denied or your HMO determines that a portion of the charge is a patient responsibility, you will receive a bill. That bill will include a summary of the services provided and an accounting of what was paid or not paid by your insurance. If your coverage is with any other health plan, you will receive a copy of the billing if there is any patient responsibility. If you are uninsured, we will work with you to select your best payment option prior to your leaving the hospital.
What is the normal billing cycle?
In most situations, Cedars-Sinai sends you a billing acknowledgement statement indicating we have billed your insurance company. This statement includes a summary of the charges for all services provided during your hospital stay. If you have further questions or would like to correct any information, we encourage you to call one of our Customer Service representatives at (323) 866-8600. Customer Service is open Monday through Friday, from 9:00 a.m. - 4:30 p.m.
How long will it take for my account to be resolved with my health plan?
Each insurance carrier is different, but we generally expect full payment from the health plan within 45 days of billing. If your insurance carrier has not paid the claim in this period of time, we may send you a notification of their nonpayment and ask your assistance by calling them to encourage prompt payment.
How much will I owe?
Once we receive a payment or denial from your insurance carrier, we will send you a statement indicating the amount you owe. This amount should be the same amount noted on the Explanation of Benefits (EOB) you received from your insurance carrier. That total is due upon receipt. If you have questions, you should contact your insurance carrier or our Customer Service representative. If your insurance carrier fails to make any payment on your account, we may seek full payment from you.
What are my payment options?
For your convenience, the Medical Center accepts a variety of payment alternatives, including cash, VISA, MasterCard, Discover, American Express and personal checks. Additional payment options are available based on personal circumstance and will be coordinated on an individual basis. Please contact our Customer Service representatives at (323) 866-8600 for assistance in identifying a viable solution.
Is it possible to get a discount?
Cedars-Sinai Medical Center offers significant discounts through its contracts with health plans, Medicare and Medi-Cal. However, because of the many state and national regulations associated with government-sponsored health insurance (Medicare and Medi-Cal) and contractual restrictions with health plans, we are not able to offer discounts, waive a co-payment or deductible, or accept the payment from your health plan as payment in full. We do, however, offer a variety of payment options for your convenience and will work with you to find the best alternative for your individual circumstance. The only justification for the Medical Center to waive any payments for insured individuals is in the case of financial hardship, which we must carefully and adequately determine and document. Discount and cash-package options are available for our patients who have no private insurance, Medicare or Medi-Cal coverage. Please contact our Customer Service representatives at (323) 866-8600 for further information.
How can I better understand my bill?
Healthcare charges are complex and include confusing clinical terminology. To simplify the information for you, we include an easy-to-understand summary of charges by category on all bills and statements. Should you wish to receive an itemized bill detailing charges in each category, please contact our Customer Service representatives at (323) 866-8600. You may also request this information through our Automated Voice Response system at the same number, Monday through Saturday, 7 a.m. to 8 p.m.
What if I don't have health insurance?
Our priority is to find payment alternatives that will work for you and will fully resolve your financial obligation. In addition to accepting cash, checks and most major credit cards, our Customer Service representatives can work with you to develop an acceptable payment plan in appropriate circumstances. For some services and procedures, we are able to offer flat-fee cash packages or discounts to customary charges. For those who may be eligible for state support, we will help you apply for and submit Medi-Cal claims. In addition, if you meet the criteria for financial hardship, some level of payment waiver may be available. Whatever the final agreement, however, you are expected to meet your financial obligation for services provided on a timely basis.
What other bills can I expect to receive?
Physician charges are not
included in Medical Center billings because in California, physicians may not be directly employed by a hospital, even if they work in a hospital. Therefore, if you received services from any physician(s) during your stay at Cedars-Sinai, you will receive a separate bill from that doctor. This may include radiologists, anesthesiologists, pathologists and others.
Please note: Physicians who treated you may or may not be contracted with your health plan. Please contact those physicians directly for questions regarding their billings. Hospital-based physicians associated with Cedars-Sinai include the following:
|(Also known as Pathology Consultants Medical Group)|
|Phone: (866) 222-4160|
|Phone: (323) 866-8800|
|Alt Phone: (800) 851-0211|