The hospital will bill your insurance carrier shortly after health care services have been provided. As a convenience to you, we will only send you a billing statement after your insurance company has paid and there is a balance due from you, or in the event we are unable to obtain payment from them.
Self Pay Discount
Patients without health insurance may receive a discount off of their hospital bill. An additional discount may be granted for pre-payment of hospital services or prompt payment of the hospital bill.
Processing Your Bill with Your Insurance
If you have current insurance coverage, the hospital
will bill your insurance carrier shortly after health
care services have been rendered.
As a convenience to you, we will only send you a billing
statement after your insurance company has paid and
there is a balance due from you, or in the event we are
unable to obtain payment from them.
It’s Important to Know if you Need Pre-Certification
It is essential for you to know if your insurance requires pre-certification in order for payment to be made for your services. If pre-certification is required, please inform your physician immediately upon arrival so there will be no delays in processing your registration and/or admission to the hospital. Please help us protect you from having your insurance claim denied for failure to pre-certify. Also, failure to re-certify additional inpatient days may result in reduced benefits or denial of your insurance claim.
If you Don’t Have Insurance
In the event you don’t have insurance you will be asked for a deposit prior to receiving services. A bill will be sent shortly after services are rendered requesting payment of the balance due. If you are unable to pay the entire amount, or wish to make payment arrangements, please contact Patient Financial Services Department at the phone number on your bill.
Froedtert & the Medical College of Wisconsin serves the community by providing medical care to all patients regardless of their ability to pay. If you are without health insurance, a financial counselor can help you find out if you are eligible for available programs including GAMP, Medicaid, and the Financial Assistance Program. You can reach a Financial Counselor at 800-466-9670.
Financial Assistance is available to patients with an identified need, including uninsured patients and patients who are insured but can’t afford their deductible and co-insurance. We can determine if you qualify for Financial Assistance based on your income, expenses and assets.
Medicare: Inpatient vs. Observation Stay
When you are cared for in a hospital, your physician must report your status for Medicare billing purposes. Medicare designates two categories of hospital care — inpatient and outpatient/observation. Many illnesses that in the past were treated as an “inpatient” hospital stay are now treated as an “observation” stay. While the two names are different there is no difference in the care you receive.
The hospital and your physician will determine the best manner in which to meet your individual needs. In some cases, an observation admission may be followed by an inpatient stay. Inpatient versus observation status is determined by the severity of the illness and the complexity of treatment — not by how long a patient stays at the hospital. The quality of care and level of nursing and physician involvement are the same under either inpatient or observation status.
There are, however, some important differences with an observation stay:
- The stay is billed under outpatient services or Medicare Part B.
- Patients are responsible for the cost of self-administered medications such as oral pills and insulin.
- Time spent in observation does not count toward the 3-day qualifying stay required by Medicare before Medicare will pay for services at a skilled nursing facility or subacute care unit.
We want our patients and families to be informed about the difference between inpatient and observation stays under Medicare rules. If you have questions regarding your coverage, please contact your Medicare provider.