Patient Friendly Billing

Following treatment at The Nebraska Medical Center it is likely a patient will receive a number of correspondences regarding their treatment and have many questions about detailed billing and payment options.

Expected Statements

The following is a list of statements a patient may expect to receive if some or all their services were received at The Nebraska Medical Center:

• Explanation of benefits from patient’s insurance company details
• Patient Liability Statement from The Nebraska Medical Center
• Detailed list of hospital charges from The Nebraska Medical Center
• Bill from individual physicians for their services
• Bill from a physician you did not see, for such services as radiology imaging review, pathology specimen analysis, consultations, and anesthesia during surgery
• Detailed list of laboratory test and charges

In some cases a bill from The Nebraska Medical Center may be received even if a patient did not visit the hospital. It is likely a specimen was sent to The Nebraska Medical Center laboratory for analysis.

Detailed List of Charges Sample

Understanding Insurance Company’s Explanation of Benefits

Your insurance company will send you an explanation of benefits (EOB) summarizing the payment and the balance you are responsible for. If you have any questions about the amount paid, or not paid, by your insurance company, please call

Your insurance company's customer service number on the back of your insurance card or on the explanation of benefits.

Understanding Patient Liability Statement

After The Nebraska Medical Center receives a payment from the insurance company, the hospital will send the patient a patient liability statement for any balance due. The patient liability amount on the EOB should match the patient liability amount for the same date of service on your hospital statement. Click here to see an example of a Patient Liability Statement.

Schedule an Appointment with a Patient Financial Counselor

If there is a discrepancy between these amounts, please contact the hospital’s Patient Financial Services between the hours of 7 a.m. and 5:30 p.m. Monday through Friday to schedule your appointment.

Directions/Map

Understanding Laboratory Statements

A patient may receive a list from the laboratory detailing the tests performed and analyzed. These statements are often written in insurance coding and patients may struggle to understand each line item. The Nebraska Medical Center recommends visiting LabTestsOnline.org to clarify this statement. LabTestsOnline.org is a third party website which provides useful information regarding lab tests and terminology.

Patients with Insurance Coverage

The Nebraska Medical Center will submit a claim on your behalf. After you are discharged from the hospital or receive outpatient services at the hospital, you will receive a detailed list of charges. No payment is due from you at this time. Please review the detailed list of charges carefully. Please contact the hospital’s Patient Financial Services between the hours of 7 a.m. and 5:30 p.m. Monday through Friday with questions.

• Phone (402) 559-3140
• Toll-free (888) 662-8662
• Submit a question

Patients with No Insurance Coverage

Several days after you are discharged from the hospital or receive outpatient services at the hospital, you will receive a detailed list of hospital charges. Payment for these services should be made after receiving the detailed list of charges or Patient Financial Services should be contacted to make arrangements for payment. Please review the detailed list of charges carefully. Please contact the hospital’s Patient Financial Services between the hours of 7 a.m. and 5:30 p.m. Monday through Friday to make payment arrangements.

Phone

(402) 559-3140

Toll-free

(888) 662-8662

Payment Options

Payments may be made by check, money order, or credit card (MasterCard, Visa, Discover, or American Express). Please return the top portion of your bill with your payment. If you are an employee of The Nebraska Medical Center you may make arrangements for payroll deduction by stopping at ACCESS Services or Patient Financial Services. If paying with a web-based or electronic payment system, please include your responsible party identification number with the payment.

Financial Assistance

Financial assistance is available for those who qualify. If you do not have insurance, please contact ACCESS Services at (402) 552-3251 or toll-free at (800) 552-8802. Arrangements can be made for a Financial Counselor to meet with you and family members to assess financial needs and options. Customer service representatives may be reached by calling (402) 559 -3140 or toll-free at (888) 662-8662 from 7 a.m. to 5:30 p.m. Monday through Friday to discuss financial assistance or make payment arrangements.

Meeting in Person with Customer Service or Financial Counselor Staff

Patient Financial Services representatives are available for one-on-one meetings Monday through Friday. Please call our offices at (402) 559-3140 or toll-free (888) 662-8662 to schedule your appointment at either of the following locations:

Phone

(402) 559-3140

Toll-free

(888) 662-8662

Fax

(402) 559-8667

Interpretive Services

Interpreters are available for any appointment.

Pre-Registration Form [Español]

Payment Options

In an effort to assist our patients and benefit the community, The Nebraska Medical Center has several financial options available for our patients. Financial assistance and payment programs are available to those who qualify. Additional questions regarding financial options can be addressed by customer service at 402-559-3140 or by a contacting a financial counselor directly at 402-559-5346. In addition, The Nebraska Medical Center offers several payment options for outstanding patient balances to assist you with resolution.

Payments may be made to your account using any of the following methods:

• Check
• MasterCard
• Money order
• Discover
• Debit card
• American Express
• Visa
• Online at www.NebraskaMed.com

Posting of Payments

Payments received will be applied to the oldest date of service unless you specify an account number and the service date payments should be applied. Indicate the account number and date of service you would like the payment to be applied to by writing them on your check or in the “Amount Paid” box on the payment stub.

Financial Questions

If you have any questions regarding your bill, need to make payment arrangements, or if your balance does not match your records, please call, visit our office or email Patient Financial Services.

Financial Counseling

Financial counseling services are provided by a team of professional financial counselors trained in both general financial counseling and specialized financial counseling for transplant patients. The financial counseling team is responsible for assisting all patients, staff and physicians with insurance, billing and various program needs.

Cost estimations for procedures as well as point-of-service and/or co-payment estimates are routinely provided for many procedures and are also available upon request. This information is provided to assist in educating patients about their expected portion of the bill so they can make informed decisions. When calling a financial counselor for assistance, please be prepared to provide the following information:

• Patient name
• Medical record number (if available)
• Insurance information (if available)
• Detailed explanation of patient’s need

If calling for cost estimates, please be prepared to provide the following information:

• Patient name
• Medical record number
• Date of service
• Location of service
• Current Procedural Terminology (CPT) code

Registration

We are pleased that you and your physician have chosen our facility.

Our goal is to make your registration as smooth as possible. To assist in this registration, please complete and return the pre-registration form at least five days before your scheduled visit. View details on how to pre- register.

Please contact your insurance company before your hospital visit to meet any pre-authorization requirements. If these requirements are not met, your benefits may be reduced, leaving you responsible for paying most or all of your hospital expenses. Patients covered by Medicare will also need to complete the Medicare Secondary Payer Questionnaire (at the end of this page).

We appreciate your cooperation in assuring that this personal and insurance information is up-to-date.

Determining In Network versus Out-of-Network Coverage

Please verify with your insurance company, prior to receiving treatment, whether or not The Nebraska Medical Center is an in-network facility. The Nebraska Medical Center may be contracted with your insurance company; however, your plan may not be included.

We also recommend that patients verify that physicians who will be providing care are in-network providers for their insurance. Hospital charges may be in-network but some of the physicians who provide services at The Nebraska Medical Center may not. It is the patient's responsibility to know which providers are in his/her network.

Pre-Certification

Many health insurance companies now require pre-admission certification, pre-authorization, or a second medical opinion before payment is made for an admission and/or outpatient treatment at a hospital. We recommend that patients call their insurance company to ensure that these requirements are met prior to your treatment.

Downloads

These files require Adobe Acrobat Reader available here

• Medicare Secondary Payer Questionnaire [English]
• Medicare Secondary Payer Questionnaire [Español]

The Nebraska Medical Center participates with several insurance plans and/or networks. Please verify with your insurance plan The Nebraska Medical Center is an in-network facility, prior to receiving treatment. It is also important patients verify all physicians providing care are contracted with his/her plan. Hospital services may be contracted however some physicians who provide services at The Nebraska Medical Center may not be. It is the patient's responsibility to know which providers are in his/her plan.

The insurance plans listed below are contracted for general services only. Please click here for a list of plans contracted specifically for transplants.

Current as of March 1, 2011

AARP MedicareComplete provided by SecureHorizons

UnitedHealthcare's Medicare Advantage Plan

Advantra from Coventry Health Care

Coventry's Medicare Advantage Plan

Aetna

Not directly contracted - see Midlands Choice for additional information

Blue Cross Blue Shield of Nebraska

• Blue Traditional (Indemnity)
• BlueClassic (Indemnity)
• Blue Preferred (PPO)
  • Out-of-state PPO plans have access to network providers through Blue Card Program
• Blue Pride (PPO)
• MedicareBlue PPO (Regional Medicare Advantage PPO)
• Network Blue (PPO)

Century Health Solutions

PPO network

ChoiceCare

See Humana

Cigna

Not directly contracted - see Midlands Choice for additional information

Corvel

PPO and Workers Compensation

Coventry Health Care of Nebraska / Coventry Health & Life Insurance Company

• Advantra from Coventry Health Care (Medicare Advantage plan)
• Coventry Health & Life Insurance Company (PPO)
  • Out-of-state PPO plans have access to network providers
• HMO
• HRA Tier 1
• POS
• Open Access
• Coventry One (Individual Product)
• Coventry Nebraska (Managed Medicaid Plan)
• Extraordinary Care Advantage (HMO) Benefit plan for The Nebraska Medical Center employees only
• Extraordinary Care Plus (PPO) Benefit plan for The Nebraska Medical Center employees only

Coventry Nebraska

Nebraska Medicaid Managed Care Plan

Coventry National Network (formerly known as First Health Direct)

PPO Network

First Health

PPO Network

First Health Direct

See Coventry National Network

GEHA (Government Employees Health Association)

PPO

Health Partners

Not directly contracted. See Midlands Choice/Cigna for additional information

Humana

• PPO - ChoiceCare Network
• Humana One - PPO - ChoiceCare Network
• Humana Choice - PPO (Medicare Advantage Plan)
• Humana Gold Plus - HMO (Medicare Advantage Plan)

Macori/Maksin

UNMC Student PPO Health Plan

Magellan

Mental Health Network
Contracted for Nebraska Medicaid recipients only

MedicareBlue PPO

Blue Cross Blue Shield Medicare Advantage PPO Plan

Medicare Complete

See SecureHorizons by UnitedHealthcare

MHNet

Mental Health Network

Midlands Choice

PPO Network

• Aetna PPO, POS, Open Access Select, AHF & SRC plans access the Midlands Choice network
• Cigna PPO, EPO & Open Access Plus plans access the Midlands Choice network
  • Cigna plans with the "Away From Home Care" logo have access to the Midlands Choice network
  • Health Partners with ?Away From Home Care? logo have access to the Midlands Choice Network

Multiplan

PPO Network

OHARA

Workers Compensation

PPO USA

PPO Network

Principal Financial Group/Principal Life Insurance

Must access a contracted network to be considered in-network. Check ID card for Managed Care Network/Preferred Provider Organization

Share Advantage

Nebraska Medicaid Managed Care Plan

SecureHorizons by UnitedHealthcare

UnitedHealthcare's Medicare Advantage Plan

TRICARE

• Prime (HMO/POS)
• Standard (PPO)

United Behavioral Health

Mental Health Network
Contracted for professional services only The Nebraska Medical Center facility is not contracted

UnitedHealthcare of the Midlands Network, Inc.

• AARP MedicareComplete provided by SecureHorizons (Medicare Advantage Plan)
• Choice (Open Access)
• Choice Plus (PPO)
• Definity Health (HRA/HSA)
• Evercare (Medicare/Medicaid Care Coordination Program)
• Golden Rule (PPO)
• Managed Indemnity (Indemnity)
• SecureHorizons by UnitedHealthcare (Medicare Advantage Plan)
• Options PPO (PPO)
• Select (HMO)
• Select Plus (POS)
• Share Advantage (Managed Medicaid Plan)

Financial Disclaimer

The Nebraska Medical Center offers the information on this Web site for general informational purposes only. Such information is subject to change without notice and changes may not be reflected on the Web site. While The Nebraska Medical Center has endeavored to make sure the information contained in this site is accurate, The Nebraska Medical Center does not guarantee the accuracy of such information, and it is provided without warranty or guarantee of any kind. Inclusion of such information is not a guarantee of coverage by any provider or for any services. Therefore, it is important that you verify provider participation and benefit coverage with your health plan or your plan administrator directly since provider network participation and covered services are subject to change.

The Nebraska Medical Center assumes no liability for any direct, indirect or other damages arising out of the use of this Web site.

If you have any questions regarding The Nebraska Medical Center's participation in your health plan please contact the Managed Care department at (402) 559-2934 or email us. The Managed Care department is available Monday through Friday from 8:00 AM until 5:00 PM.