Q: If my insurance has paid, why do I still have a balance?
A: Insurance does not always pay the entire claim. Portions of the claim are designated as the patient’s responsibility, such as deductibles, co-insurance, and/or any non-covered charges. Any portion of the bill not covered by insurance will be billed to the responsible party.
Q: What if my insurance does not pay?
A: The hospital expects payment within 45 days from billing. If payment is not received, the hospital will look to the patient or responsible party for payment on the account. Please call your insurance company to expedite the payment process.
Q: Who is responsible for providing additional information to the insurance company?
A: This depends on the required information. The hospital will make every effort to provide any and all information within their ability to the carrier.
Some information may be needed from the doctor and/or the patient. In these situations, it is the patient’s responsibility to ensure all information is sent to the insurance company.
Q: How long do I wait for my insurance to pay before it becomes my responsibility?
A: Although 45 days from billing is sufficient for your insurance to pay or respond, sometimes it may take longer.
We will make every effort to bill your insurance and provide the requested information, but we do suggest that the patient take an active role in the resolution of the claim by calling his/her insurance company to ensure the claim is processed timely.
Q: Why didn’t my insurance pay?
A: There are many reasons why insurance companies may not pay for certain services. Sometimes, the denial information provided to the hospital is limited.
We suggest that you contact the insurance company for detailed information as to why payment was not made.
Q: What is the amount shown on my statement as "insurance adjustment?"
A: These are discounts your insurance company negotiated with Tanner Health System through a contractual agreement. You have no financial responsibility for these amounts.
Q: Why did my insurance company send me a questionnaire?
A: Often, insurance companies must gather additional information from policyholders before processing payments. Usually, they are reviewing the claims to see if services were related to an accident whereby there may be another insurance payer responsible for payment.
Also, they may be looking for pre-existing conditions. It is important that you return the questionnaire as soon as possible in order for your claim to be processed accurately and timely.