Financial Services Frequently Asked Questions
Why do I have a hospital charge when I was only seen in a clinic?Why do I have a hospital charge when I was only seen in a clinic?
Because Baylor Scott & White clinic facilities are outpatient departments of Baylor Scott & White Hospital, Baylor Scott & White hospitals are responsible for the administrative and facility costs of the clinics. Therefore, the bill you receive for services rendered at a clinic facility will include both a professional fee (to cover the costs of the services provided by the physician and other professional personnel at the clinic) and a facility fee (to cover the costs of maintaining the facility, equipment, support staff, etc. incurred by the hospital).
How will I know how much I owe?How will I know how much I owe?
Baylor Scott & White Health will verify for active medical coverage with your health plan and will provide information regarding your coverage and an estimate of the amount you may owe for your clinic or hospital service. This amount may include a deductible, co-insurance, co-payment, charges for non-covered services and any outstanding balance amount. You may be asked for payment of this amount prior to or during registration, check out during your clinic visit or discharge from the hospital.
After your health plan has processed your clinic/hospital bill, it will send you an "Explanation of Benefits" notice that provides the amount that has been paid, any non-covered or denied amounts and the remaining balance that you owe. Please review this carefully and call your health plan or the hospital immediately if you have questions or concerns. The hospital also will send you a bill for any remaining amount due (deductible, co-insurance, co-payment, non-covered charges, outstanding amounts).
Will Scott & White accept my insurance?Will Scott & White accept my insurance?
We accept most major insurance plans providing health care coverage.
Please note: It is ultimately the responsibility of the patient or the patient's guardian to verify benefit coverage (what costs will be paid for by his or her health care insurance provider) and obtain any pre-certification or pre-authorization that is required by his or her health care insurance provider.
If the patient's health care insurance is among those that we accept, Baylor Scott & White Health will submit a claim to the insurance company so long as the patient or the patient's guardian has assigned payment of benefits to Baylor Scott & White Health.
What if my Baylor Scott & White clinic or hospital is "out of network," can I still go there?What if my Baylor Scott & White or hospital is "out of network," can I still go there?
In an emergency you should go to the nearest hospital. Your health plan will generally cover emergency department costs or transfer you to an "in network" hospital, if it is safe to do so. If you elect to go to an "out of network" hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Be sure you understand the "out of network" options of your health plan.
What does it mean when an insurance company reimburses Baylor Scott & White Health their “reasonable and customary” rate?What does it mean when an insurance company reimburses Baylor Scott & White Health their “reasonable and customary” rate?
Reasonable and customary (or Usual and customary) – Commonly charged fees for health services in a certain area. The use of fee screens to determine the lowest value of provider reimbursement based on:
- The provider’s usual charge for a given procedure
- The amount customarily charged for the service by other providers in the area
- The reasonable cost of services for a given patient after medical review of the case
Most health plans provide reimbursement for reasonable and customary charges, although no universal formula has been established for these rates.
Why are personal payments sent to a Dallas, Texas address when Baylor Scott & White Health is located in Temple, Texas?Why are personal payments sent to a Dallas, Texas address when Baylor Scott & White Health is located in Temple, Texas?
In order to optimize automated payment posting technology, Baylor Scott & White Health utilizes a payment processing center which is located in Dallas.
Why are today's healthcare prices so high?Why are today's healthcare prices so high?
Baylor Scott & White Health is a multi-specialty, teaching facility who strives to provide the very best medical care utilizing the latest technology. Our fee schedules reflect the cost of delivering the level of healthcare that our patients desire and deserve. Our prices are simply driven by the increasing costs associated with delivering this high quality healthcare.
How can I be sure my health plan will pay my hospital bill?How can I be sure my health plan will pay my hospital bill?
Some health plans require a patient to pre-certify certain services or to notify them within a certain period of time after becoming hospitalized. If your hospitalization is not an emergency, we encourage you to review and understand the coverage provided by your health plan. (On elective procedures you should talk to your doctor and your health plan about coverage.) Please discuss any insurance eligibility of payment concerns with the Baylor Scott & White Health staff member at the time of registration or with a financial counselor as soon as possible
What if I don't have health insurance?What if I don't have health insurance?
Baylor Scott & White Health will not withhold or delay emergency services because of a patient's inability to pay. If you do not have health insurance and receive hospital services including emergency services, please call our CustomerCare department at 1-800-994-0371. CustomerCare will review payment and funding options that may be available to you. These could include an uninsured patient discount, applying for Medicaid, Children’s Health Insurance Plan, charity care or other financial assistance programs.
What are the Medicare Deductibles?What are the Medicare Deductibles?
Information on Medicare deductibles and other Medicare beneficiary information, such as name changes, is available at www.medicare.gov or call 1-800-Medicare.