Understanding the Registration and Billing Process
Many steps are involved with registration and healthcare billing. These
are the typical steps between the time you receive non-emergent
medical services and you receive your bill:
When you go to your hospital or health care provider's office
for care, the admitting or office registration department*
gathers information about you and/or the person responsible for
paying for the services (the guarantor) and the insurance
organization that will be billed. You will be asked to
provide: insurance card, photo identification, and a
prescription or order. Your physician may also be
requested to obtain a referral or pre-certification for your
*Note: Main Line Health now offers paperless registration using
computer kiosks at some locations. This provides a
streamlined registration process for our patients and reduces
our impact on the environment.
You will be asked to sign several documents, including:
Acknowledgement that you have received a Notice
of Privacy Practices
Advanced Beneficiary Notice
(some Medicare beneficiaries)—Advises you that
the test/procedures performed may not be covered
by Medicare. The purpose of the Advanced
Beneficiary Notice is to let you know in advance
that these services may not be covered and to
advise you that you will be responsible for
payment of these related charges
Advance Directive: You are also asked about an
Advanced Directive when you register for inpatient or outpatient
hospital services. Formal Advanced Directives are documents
written in advance of serious illness that state your choices
for healthcare, or name someone to make those choices, if you
become unable to make decisions. Medicare and hospital
accrediting bodies (organizations that oversee the quality of
care provided by hospitals) require we ask each patient, at each
visit, whether or not the patient has a current Advance
Directive. This could be in the form of a living will,
healthcare power of Attorney, or both. Through these
documents you can make legally valid decisions about your future
Most insurance plans require that you pay a co-payment,
co-insurance and/or deductible for your healthcare services
(patient responsibility). In some instances, your insurance
carrier may require a pre-certification for certain outpatient
services that have been prescribed for you. This is the
physician’s responsibility to obtain from your insurance
company. If your physician has not obtained a pre-certification,
your test or procedure may be cancelled or delayed.
Main Line Health representatives will present you with an
estimate of your co-payment, coinsurance and/or deducible based
on our understanding of your individual insurance
coverage. It is our expectation that this co-payment,
coinsurance, or deductible be made at time of service.
For your convenience we accept cash, check, Visa, MasterCard,
American Express and Discover Cards.
After the care or treatment is performed, the hospital’s
billing office files a claim with your primary insurance
organization for services. In many cases, payment is sent
directly to your health care provider, not to you.
If your insurance organization will not pay because of a problem
with the information provided, the billing office tries to
correct the information and re-files the claim.
After payment is received from the primary insurance
organization, the billing office will file claims with any
secondary insurance organizations.
When all insurance payments to the hospital have been processed
and paid by your insurance company, you are billed for any
remaining unpaid balance. You will receive a statement by mail.
As a courtesy to you, a payment representative (who will clearly
identify himself or herself and will ONLY ask you verifying
information) will call you shortly after mailing your first bill
to determine if there are any matters which are unclear. We
encourage our patients to use this service call to address any
unanswered questions regarding the billing process.
It is important that you are familiar with your benefits and the extent
of your medical coverage. We suggest that you contact your insurance
carrier before scheduling an elective procedure and before services are
Most hospital visits involve both physician and hospital
resources. Please be aware that physician charges are billed
separately according to the terms of your insurance plan. A list of
typical physician service organizations and contact information can be
found on the Billing and
Physician Group Contacts page. It is possible you will receive
only one hospital bill, but several physician bills depending on the
complexity of your care.
A Special Note to New and Expecting Parents
Most insurance companies require that a new child be added to the
parent’s policy within 30 days of birth. Failure to do so could result
in non-payment for the child’s hospital services by the insurance
company. If this occurs, the parent/responsible party will be
billed for the services. Please check with your insurance company to
determine when they require a new child to be added to the policy.
Charity Care Policy
No patient will be refused emergency treatment at Main Line
Health because of their financial status.
For more information, call 1.866.CALL.MLH.