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Billing Questions

I have insurance, why did it not cover my mammogram?

Most insurances pay for preventative tests based on age. Also only one is allowed in a certain period of time, for example once a year. You need to verify with your insurance what their individual time frame is.


When I have labs drawn at the doctor’s office I don’t have to pay an additional co-pay? Why am I being charged by the hospital for my labs?

If labs are drawn in the physician’s office they are either sent to the hospital or an outside lab such as LabCorp. When they are sent to the hospital, the insurance considers this to be an outpatient hospital procedure therefore the claim is processed as outpatient not as physician office visit.




If I go to Tri County Orthopedics in Elkin and have an XRAY, I only have to pay the office co-pay. Why do I get charged an additional co-pay when I come to the hospital Orthopedic office?

Tri County has their own XRAY department and radiologist within the office and can file the XRAY and radiologist fee on the same claim. If you are treated at the hospital clinic, the XRAY is done by the hospital radiology department and therefore has to be filed to the insurance company as an outpatient hospital claim.


FREQUENTLY ASKED INSURANCE BILLING QUESTIONS

I have two insurances, Medicare and a supplement. Why am I getting a bill?

Medicare will not pay for medications a patient receives during any outpatient visit. This includes Emergency room visits and an overnight stay as an Observation patient. Observation is considered Outpatient service. Most supplement plans will not pay for anything that isn’t covered by Medicare. We can, however, give you an itemized list of the medications you received which can be turned into your Part D plan for possible reimbursement to you.


I have been in other, bigger hospitals and never had to pay anything since I have Medicare and a supplement insurance. Why do I always have to pay for medicines  when I come to Alleghany Hospital?                    

At a larger hospital, like Baptist or Forsyth, more than likely you were on an inpatient level of care for which medications would be covered. Here at Alleghany you were an Observation patient.    


      Why did my insurance not pay more on my bill?

Most insurance policies have a deductible as well as co-pays and co-insurances which are patient responsibility. If you haven’t been to the doctor or hospital prior to this stay, you have not met the deductible and or co-pay.