I received a letter telling me that I need to update my Coordination of Benefits. What do I do with this?
Coordination of Benefits (COB) happens when your insurance plan wants to confirm if either you, or someone in your family has health benefits under more than one insurance plan (including medical benefits under motor vehicle insurance and personal injury protection insurance). COB is often required each calendar year or based on diagnosis. The insurance company will not process any claims until this is updated by the insured. If you received a form from your insurance company, please fill it out and return it as soon as possible. There also may be a number you can call. If you did not receive a form, please call your insurance company by using the customer service number on the back of your insurance card.
I just had a baby. What do I need to do to make sure my insurance covers the bills?
Most employer-based insurance plans allow a specific period of time to enroll a newborn in the plan. You will need to contact your HR department to see what the exact process is, but it usually involves completing and returning a form. If this is not done in a timely manner, coverage may be denied and you will be responsible for your newborn’s bills. Akron Children’s is not able to do this for you.
How can I be sure my insurance provider will pay my bills?
Your health plan may:
- Require certain services to be authorized or pre-certified before you receive them
- Require you to notify them within a certain period of time after services are rendered
- Require you to provide information regarding any other insurance for the patient
Find out your health plan's requirements by reading the information given to you by your insurance provider or employer, or by calling your insurance provider directly. You are usually provided with a summary plan document or a website that has all coverage information including your yearly deductible, coinsurance, copay, in and out of network provider directory and benefits.
How will I know how much I owe?
You may request an estimate of your financial responsibility prior to service at Akron Children’s. Information needed includes the service’s CPT code and your insurance details. Self service estimates can be obtained through MyChart. Estimates can also be obtained through financial counseling by calling 330-543-8500.
Your health plan may require a copayment or deductible that will be due during appointment registration or hospital discharge. Check with your insurance provider on the amount that you will be responsible for at this time.
Following your healthcare services, your insurance provider will send you an explanation of benefits (EOB), which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying.
We encourage you to review your EOB and compare it to your Akron Children’s billing statement. Please call your insurance provider or a billing representative if you have questions or concerns.
I received a billing statement. How do I know my insurance company paid its portion?
Your statement has an area where the amount paid by insurance and amount adjusted (if any) is detailed. This information will appear on the first statement for that service. Your insurance company will also send you an explanation of benefits (EOB) that will explain how your claim was processed. It will include information on how much financial responsibility you have including any deductible, coinsurance and/or copay amounts. If you have additional questions about insurance payments, please call your insurance company directly. The insurance company's phone number is usually printed on the back of your insurance card.
What if I forget to bring my insurance information to the appointment?
You will be registered as "self-pay" during registration, which means you are responsible for paying the entire bill. However, you may contact us to provide your insurance information after your appointment by calling 330-543-8500.
How does my insurance company receive the claim for health care services?
In most cases, Akron Children's files the claim with your insurance company. Please make sure that we have your correct insurance information on file and, if you have more than one insurance, all of the necessary information usually found on the insurance ID cards.
Does Children’s bill secondary insurances?
Yes, Children’s is dedicated to helping you receive full benefits from your insurance provider. You will be asked to provide complete insurance information upon registration. Be sure you have a copy of your insurance cards at that time. As a service to you, we will submit secondary claims along with required EOBs to your insurance provider. However, if your insurance provider doesn't make payment within 60 days, we will ask you to pay the amount owed.
Why are some of my bills from the hospital covered by my insurance, while others are not?
Hospital coverage often has a deductible or out-of-pocket expense that you are responsible for paying. Since each plan can be different, we encourage you to carefully review your benefits. Additionally, your plan may not cover specific services. You should check with your insurance prior to having any service performed to verify coverage.
Why did I receive a bill for a doctor I did not see?
Certain physicians help with your medical care even though you may not meet them. Commonly, these are the doctors who read your lab results, X-rays and EKGs, among others.
Why do I receive billing statements from the hospital when my child was never there?
Akron Children’s provides a wide range of medically related services for independent clinics, area physicians and other hospitals. For example, a pediatrician or health center may refer lab work to Akron Children’s for testing or analysis. When this occurs, the bill for the lab services will come from Akron Children’s.
We also provide pediatrician services to newborns at area hospitals for evaluation and/or discharge upon request. That bill would be separate from the actual birth.
What does “Physician Visit Level 3” refer to on my bill?
Akron Children’s uses five levels to describe the time and complexity of physician visits, with Level 1 being the lowest and Level 5 being the highest. This is standardized coding across the healthcare industry.
Why was my last payment divided and applied to the bill in two separate places?
We post your payment to the oldest dates of service first unless you specifically indicate otherwise. On your billing statement, we itemize both the charges and your payments by date.
My child's medical bills are adding up fast, and I can't afford them. How can I get help?
We are committed to providing healthcare to every child who needs it, regardless of the family’s ability to pay. Our financial counselors can help you manage your child’s medical bills. Please contact them at 330-543-8500.
May I set up a payment plan to make installment payments on my bill?
Yes, Children’s offers payment plans that are interest-free. Minimum payments are $25 and can be extended up to 18 months. Please contact customer service if this does not meet your needs to discuss other possible options. You will be required to demonstrate financial need.
I received a letter stating my account has been referred to a collection agency or collection attorney. Why was this done and what should I do?
Before an account is referred to a collection agency, you will receive four billing statements from Akron Children’s. You may also receive a phone call from our billing office. If you have not made a payment or payment arrangements after these steps have been taken, the account will be referred a collection agency. You must contact Children’s to establish a payment plan. Making regular payments without one will not prevent an account from going to collections. These agencies act under the direction of Children’s. Once an account is placed with an outside collection agency, we ask that you work directly with the agency to resolve the balance. If you fail to do so, additional collection actions may take place to resolve the balances you owe.
I tried to get information on an account but was told by Customer Service that they couldn’t talk to me. Why not?
There are situations when someone not directly responsible for a patient needs to have access to HIPAA-protected details of the patient’s account. In order to do so, we must have a signed and dated release of information (ROI) form on file from the patient’s parent/guardian. It is also important to note that having insurance coverage on the patient does not automatically make you a guarantor on the account or provide you with access to account information. Click here to download a copy of the ROI, complete it and email it to BillingServices@akronchildrens.org or mail it to:
Akron Children’s, Customer Service Department
PO Box 74477
Cleveland, OH 44194-0577
Please allow 7-10 business days for processing before contacting Customer Service to obtain the needed information. If this is not in place prior to calling, we are not permitted to release any protected information. If you have any questions, you can call Customer Service at 330-543-8500.
