Billing & Insurance
PIH Health is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company, and you have the final responsibility for payment of your hospital bill.
We have several payment options available to assist you in paying your bill. If you believe you cannot pay all or some of your bill, you may qualify for financial assistance.
Your bill reflects all of the services you receive during your stay. Charges fall into two categories:
- A basic daily rate, which includes your room, meals, nursing care, housekeeping, telephone, and television
- Charges for special services, which include items your physician orders for you, such as x-rays or laboratory tests.
If you have certain tests or treatments while in the hospital, you may receive bills from physicians you did not see in person. These bills are for professional services rendered by these doctors in diagnosing and interpreting test results while you were a patient.
Pathologists, radiologists, cardiologists, anesthesiologists, emergency physicians, and other specialists perform these services and are required to submit separate bills. If you have questions about these bills, please call the number printed on the statement you receive.
When making an authorization decision, PIH Health Physicians medical professionals consider your individual circumstances, the appropriateness of the service requested, and the benefits provided by your health plan. We also use resources such as outside experts and nationally recognized treatment guidelines. We do not reward practitioners or other individuals for issuing denials of coverage of service. We have no financial incentives for Utilization Management decision-makers to encourage decisions that result in underutilization.
If you have any questions about the authorization process or a specific referral, please contact your primary care physician’s office or the PIH Health Patient Services Department at 562.947.8478, Ext. 82199. A collect call will be accepted at this number.
If your referral request is denied, you will receive written notification which will inform you of the reason for the denial. The specific utilization review criteria used to make the determination is available upon request from our Utilization Management Department at 562.789.5401 Ext. 81062. If you are not satisfied with the decision, you may file an appeal through your health plan.