Patients and Visitors
Insurance and Billing

Coverage and Billing Information


Patients with Health Insurance

  • Our Insurance Billing department will file claims with your insurance company. A current insurance card is essential to the accurate processing and benefits application of your claim.
  • Private rooms are not covered by insurance companies unless medically necessary and ordered by your physician.
  • Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain test or procedures. It is your responsibility to make sure the requirements of your plan have been met.
  • Amounts not covered by insurance are the patient’s responsibility.

Patients Covered by Medicare or Medicaid

  • Medicare will only pay for services that it considers medically necessary.
  • Patients are responsible for services not covered by Medicare.
  • Check your Medicare handbook for a listing of services excluded by Medicare, or visit www.medicare.gov.
  • If you are covered by Medicaid you should bring your current card.

Observation
Observation status is chosen when the medical needs of monitoring, testing and/or treatment can reasonably be expected to be met within 48 hours. Your care may have been provided in a hospital room, however your status of observation is considered as outpatient services. An Observation stay allows a physician to make a decision about a patient’s treatment plan and may change the status from observation to inpatient for further testing and treatment or discharge the patient and continue with follow-up care. Observation stays are covered differently by insurance plans than inpatient hospital stays. You will need to reference you insurance plan for an explanation of your benefits. It is important to understand you may be responsible for any out-of-pocket expenses, such as co-payments, deductibles and certain medications, in accordance with your insurance plan. Patients covered by Medicare need to understand Medicare will not cover certain medications (i.e., those taken routinely/daily at home or orally) that are provided during an observation stay. If you have particular questions about your insurance coverage, please contact your insurance provider.

Financial Counseling
Camden Clark provides financial assistance programs based on income, expenses, and circumstances. If you have billing questions or would like to apply for financial assistance you may contact Patient Financial Services by calling (304) 424-2258.

Your Hospital Bill
You will receive a monthly statement if there is a portion of the bill that is your responsibility. After leaving the facility, call (800) 541-3160 if you have additional questions.

Depending on the type of care you receive, you may receive bills from your physician, other physicians who gave advice concerning your care, or physicians who helped interpret your test results. Questions regarding these bills should be addressed with each physician’s billing office.

Standards for Privacy of Protected Health Information
According to the federal law named the “Health Insurance Portability and Accountability Act” (HIPAA), you have rights concerning the use of individually identifiable health information. Only individuals with a legitimate “need to know” may access, use or disclose patient information. Protected health information may be released to other covered health care providers without patient authorization if used for treatment, payment, health care operations, or for public good purposes as permitted by state and federal laws. Disclosures of protected health information for uses and disclosures outside treatment, payment and health care operations require patient authorization.

While receiving care in the hospital, you may ask for your name not to be included in the hospital directory. This means that people who ask for you will be told “I have no information about this patient.” If you want to receive deliveries of cards and flowers, then your name should be included in the hospital directory. If you include your name in the hospital directory, your name will appear on a list for clergy members of your faith.

For a listing of other HIPAA privacy rights, please refer to the Notice of Privacy Practices.

If You Have a Question or Concern
The medical staff and the employees of Camden Clark seek to treat our patients with fairness and concern, recognizing their needs and satisfying them to the extent possible. The Guest Relations Department was established for you, the patient. If you have any questions or problems that have not been answered to your satisfaction or if you have a special need, call Guest Relations or dial the operator and ask for a member of the Guest Relations staff.