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Patient Business Services Frequently Asked Questions

Getting answers regarding health-care costs and insurance coverage can be complicated and frustrating. Palomar Health wishes to assist you by answering some of the most commonly asked questions and clarifying some of the misconceptions about patient financial responsibility. If you wish further information, please call a Patient Business Service Representative at 858.675.5218.

Why can't I know how much my emergency room service will cost?
The practice of identifying estimated costs for the level of care in the emergency room and its treatment could discourage the individual from remaining at the hospital to receive care to which he or she is entitled and which the hospital is obligated to provide regardless of the patient's ability to pay.

Why did I get a bill when I left the emergency room before the physician saw me?
The hospital has an obligation as an emergency department licensed provider, to treat and evaluate each patient with an initial screening exam. The medical screening exam is performed by a nurse and may consist of taking vital signs and asking pertinent questions regarding your health and symptoms. Should you elect to leave prior to receiving full emergency department services - you will be billed for the initial assessment.

How do I get an itemized bill for my medical services?
Please contact Patient Business Services at 858.675.5218 for an itemized bill.

What does the hospital bill for?
Support staff to facilitate your care (i.e., nursing, technician, room and board). Physicians and other professional services are billed separately.

What is a "contract provider"?
A contract provider is a provider of service (such as the hospital and/or physician/professional services) who "contracts" with an insurance company to provide care. Please refer to your insurance handbook.

Do you bill my primary and secondary insurance carrier?
Yes, as a courtesy to our patients. You are responsible for providing a current copy of your insurance information at each individual visit to the hospital (or associated facilities).

Why do I receive a separate fee/bill for "professional services"?
The hospital does not employ physicians. Professionals that perform their services are specialists in their fields and provide the highest level of care to our patients. These professionals are located at the hospital in order to facilitate care, but they handle their own billing from their business office.

What happens if my insurance company does not pay for all services?
As determined by your insurance company, Patient Business Services will bill the patient for "non-covered" or denied services.

Why is my bill so expensive?
We provide comprehensive services 24 hours a day, 7 days a week

How do I know how much my co-pay will be for my procedure?
Prior to your arrival, please refer to your insurance handbook and/or call your insurance company. The hospital admitting staff will also be happy to assist you in verifying your benefits at the point of registration.

Why do I have to pay my co-pay or deductible up front for services I receive?
All co-pays and deductibles as indicated by your insurance, are your responsibility and are due at the time of registration and/or discharge.

What happens if I do not pay my bill to Palomar Health?
If you have a balance due to the hospital and do not pay that balance, it may be sent to an outside collection agency.

Why did I get a call from a collection agency regarding my outstanding balance while I am in dispute with my insurance company?
Our records reflect you have an outstanding balance. The patient has a right to appeal with their insurance company. During this appeal process, the patient is still responsible for the balance due.

Additionally professionals who may participate in your care and will charge and bill separately:

  • Radiologist
  • Anesthesiologist
  • Pathologist
  • All physicians involved with your care
  • Emergency room physicians

Physicians and other professional consultants may not be contract providers with your health-care insurer. Health insurance providers choose to contract with certain professionals and facilities, as do the physicians and physician groups. Be sure to ask your insurance company or the treating professional if you have concerns regarding contracted coverage and fees. Palomar Health does not bill for professional fees. Palomar Health charges or bills do not include fees for the above professionals. They bill separately.