Doctor Bill Questions

We can assist you in several ways. If you do not qualify for any type of government programs, we can review your financial status to see if you qualify for our Financial Assistance Program.

We also provide a financial adjustment to any uninsured patient who obtains medically-necessary or emergency services from IU Health. 

Read your insurance plan booklet to be sure you have followed all the guidelines for referrals and authorizations, or call your insurance company for assistance. Failure to follow your plan requirements may result in greater out-of-pocket expenses for you. Your primary care physician plays a very important role in this process; if you receive a verbal authorization number, please provide us with this information at registration.

In order for us to give you this information you will need to have the CPT code for what you are going to be charged during your visit.

You will need to provide us with complete primary and secondary insurance information. As a courtesy to our patients, IU Health submits bills to your insurance company and will do everything possible to advance your claim. However, it may become necessary for you to contact your insurance company or supply additional information to them for claims processing requirements or to expedite payment.

We receive all of your personal and insurance information from the department with whom you first registered. If you would provide us with the correct information, we will follow up with the appropriate department to ensure that this does not happen again.

Our charge amounts are a product of our costs and the Indianapolis market. Each year, we get the publicly available MEDPAR (Medicare Provider Analysis and Review) data to ensure that what we charge is in line with what others are charging for the same services. We also need to ensure that we cover both direct (nursing, supplies, etc.) and indirect (accounting, deprecation, etc.) costs.

These bills are for the professional services that were provided by doctors who assisted in diagnosing and interpreting test results while you were a patient. Pathologists, radiologists, cardiologists, anesthesiologists, and other specialists perform these services and are legally obligated to submit separate bills. If you have questions about these bills, please call the number printed on the statement you received from them.

On February 1, 2011, IU Health implemented a new Consolidated Patient Statement (CPS) which allows us to have one bill per patient per guarantor.

All services incurred on or after February 1, 2011, will have one statement per patient per guarantor. Both physician and hospital bills will be one the same statement.

All services incurred prior to February 1, 2011, will continue to be billed separately.

No. An EOB is simply an explanation of your insurance benefits. If your EOB shows a deductible, co-insurance and/or co-payment amount on it, you will receive a bill from IU Health once we’ve received and posted your insurance company’s payment.

An EOB, or Explanation of Benefits, is a statement sent that provides necessary information about claim payment and patient responsibility amounts.

Some of the information you may see on an EOB are:

• Provider of care
• What services were covered
• What amounts were paid
• What discounts/adjustments the provider is contractually obligated to write off
• If any of the services were denied and why
• Your deductible and/or co-insurance and/or co-payment amounts

Sometimes an EOB is also called on EOP, or Explanation of Payment.

Your physician has changed from physician-based billing to provider-based billing. Provider-based billing, also known as hospital-based outpatient billing, refers to the billing process for services rendered in a hospital outpatient clinic.

Previously, your physician was doing the billing for all of the components of your visit, which included the physician’s services, the building, nurses, supplies, equipment, utilities, legal, and accounting. Now, by implementing provider-based billing, the physician is only billing for the physician services. The hospital now bills for all other components of your visit.

IU Health and our partnering physicians chose to do provider-based billing because it ensures more appropriate payments. Also, provider-based billing is the national model of practice for large, integrated delivery systems involved in patient care and is approved by Medicare. By choosing an IU Health physician, you have elected to be treated by a provider that can offer all of the amenities that come with a large, integrated delivery system.

There are several reasons why your insurance company may deny your claim. One or more of the following may apply:

• The service you received was not covered under your plan
• You did not provide the correct insurance information at the time or service
• The service you received was from a physician outside of your plan’s network
• You were not covered by the plan at the time of service

The EOB sent to you by your insurance company should explain in more detail why they denied either a portion or the entire claim. If you receive a denial from your insurance carrier and still have questions, you should contact them to better understand the reason for the denial.

Yes, our Patient Financial Service Representatives are here to assist you from 8 am – 4 pm EST, Monday – Friday, excluding all major holidays. You can find our office at 250 N. Shadeland Avenue, Indianapolis, IN 46219.

Yes. The payment will post to the oldest date of service with an outstanding balance.

On February 1, 2011, IU Health implemented a new Consolidated Patient Statement (CPS) which allows us have one bill per patient per guarantor.

All services incurred on or after February 1, 2011, will be on one statement. Both physician and hospital bills will be on the same statement. Part of this implementation included adding a new "Minimum Due" payment option. This option allows you to pay a pre-calculated minimum amount each month without any additional costs to you and without having to contact our Customer Service department.

All services incurred prior to February 1, 2011, will continue to be billed separately. For these, you may make payment arrangements to pay the balance of your invoice(s) in 12 equal monthly payments without any additional cost to you. A minimum monthly payment is $30. To set up payment arrangements, please contact our Customer Service department during normal business hours.

We received an overpayment on your invoice. Either you have paid too much on your invoice and/or your insurance paid at a later date and covered some of what you had already paid.

If you feel that you have received this refund in error, please contact our Customer Service department during normal business hours.