Billing and Finances Connecticut Children’s Medical Center provides patient financial services to help families navigate the process of billing and medical insurance. For your convenience, we have created this chart estimating your financial liability for a variety of different services. In addition, customer service representatives are available to provide copies of itemized patient bills, explain particular bills, set up payment arrangements or review what costs insurance has paid and what payments are due. Pay a bill online » Understanding the different fees » Pricing Transparency and Estimates » To contact a customer service representative, call 866-201-9261 or email firstname.lastname@example.org As a courtesy to our patients, Connecticut Children’s submits bills to their insurance companies and makes every effort to advance their claim. However, it may become necessary for a policy holder to contact their insurance provider or supply additional information required for claims processing purposes or to expedite payment. We ask our patients’ families to remember that an insurance policy is a contract between them and the insurance company, and that they have the final responsibility for payment of their hospital bill. You can request information about the cost of a diagnostic test or procedure and our hospital’s quality ratings by contacting a financial counselor at 860.545.8086, option 4. Financial Counseling Financial counselors are available to assist families who are uninsured, underinsured, or may need financial assistance or to set up payment arrangements. Counselors will assist with applying for different government programs and advise on how to proceed. Contact our financial counselors when your child is scheduled for a procedure or surgery, scheduled to be admitted, is currently hospitalized or has recently visited our emergency department or been discharged from our care. If your family does not qualify for any type of government programs, our counselors can review your financial status to see if you meet guidelines for special programs, Patient Financial Assistance, or hospital Free Bed Funds. Complete the financial assistance application and submit via email or fax to 860.545.8006. A financial counselor will respond in a timely manner. Financial Assistance Documents Financial Assistance Application Financial Assistance Application (en Espanol) Financial Assistance Policy Financial counselors are available at Connecticut Children’s main campus for assistance. To discuss a financial concern or to schedule an appointment with a financial counselor, call 860.545.8086, option 3, Monday – Friday from 8 am – 5:30 pm. Mailing address: Connecticut Children’s Medical Center Patient Financial Counseling, 2D 282 Washington Street Hartford, CT 06106 Insurance Connecticut Children’s Medical Center participates in most major health plans in Connecticut. In addition, please review your health plan provider directory and/or consult with your health plan to confirm coverage. Commercial Plans Accepted: Carrier or Health Plan HMO/PPO/EPO/POS Exchange 1199 National Benefit Fun X AETNA X Anthem BC/BS X X BCBS of Mass X Blue Cross/Blue Shield (Ind. outside of CT) PPO/EPO/POS Only BMC Health Net Plan X CIGNA X ConnectiCare X X Emblem Health X Empire Blue Cross X First Health/Coventry Health X Golden Rule X Great West Healthcare X Harvard Pilgrim X Health New England (Professional Services only for Rheumatology, Nephrology, Neuro Surgery and Cardiac Surgical Care) X Humana/Tricare Mertain Health X Multiplan X Occunet X Optum Behavioral Health (Professional Services Only) X Oxford Health Plans X PHCS X Tufts Health Plan X Tufts Health Public Plan (Medicaid) X UMR X Unicare X United Healthcare X Yale Health Plan X Government Plans: Medicaid-State of Connecticut Medicare Mass Health (Medicaid) New York State Medicaid Managed Care Connecticut Children’s participates in most managed care plans in Connecticut to make using our facilities and services as convenient as possible. Participation may vary by product and is subject to change. Access to Connecticut Children’s Medical Center may require an authorization or referral by your primary care physician or your managed care plan. If you have questions about Connecticut Children’s participation in your managed care plan, call Connecticut Children’s Customer Service at 860.837.6170. For questions regarding eligibility and coverage of services, please contact your health plan representative. Learn more about Connecticut Children’s existing billing practices and what you can expect. » Billing FAQs Why did I receive multiple hospital bills with the same account number?If you have services that are billed on a monthly (unit) billing cycle, you may receive multiple bills with the same account number; however, they are for different periods of time. Why did I receive separate bills for the hospital and the doctor(s)?These bills are for professional services provided by doctors, such as diagnosing and interpreting test results while you were a patient. Pathologists, radiologists, cardiologists, and other specialists perform these services and are legally required to submit separate bills. If you have questions about these bills, please call the number printed on the billing statement you received. Will you bill my primary and secondary insurance?You will need to provide us with complete primary insurance information. As a courtesy to our patients, Connecticut Children’s 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. Are itemized statements automatically sent to patients?No. We send summary bills to the patient. To request an itemized statement, call the business office at 860.837.6170. Do you offer payment arrangements?Yes, payment arrangements may be made by contacting customer service at 860.837.6170. Why am I receiving a refund check?There was an overpayment to your account. Either you paid too much on the account and/or your insurance paid at a later date and covered some of what you already paid. Why did my insurance deny the claim?One or more of the following may apply: The service you received was not covered under your plan Incorrect insurance information may have been recorded at the time of service; it will be important to verify that information You or the patient were not covered by your plan at time of service Can I come in and talk to someone regarding my bill?Yes, our patient financial coordinators are here to assist you Monday – Friday from 8 am – 4:30 pm. Our office is located at the main campus in Area 2D (behind the cashier). Must I register each time I come to the hospital?Yes, information gathered from patient registration is stored in our computer system. We retrieve this information each time the patient returns for services and we ask the patient to verify that the information is current and accurate. Your assistance in verifying the information is always appreciated. I don't have any insurance. Is there any help available?Our financial coordinators will assist you with applying for different government programs or will give you advice on how to proceed. We can also review your financial status to see if you qualify for hospital Free Bed funds I come to the hospital often. Is there any way that I can receive one bill?Unfortunately, because of insurance requirements, we may be required to bill each visit separately. Why is there an error on my bill?If you have questions about your bill, or believe that it is incorrect, call the customer service department at 860.837.6170, Monday – Friday from 8 am – 4:30 pm. Confidential voice mail is available after hours, and your call will be returned on the next business day. What is a co-payment?A co-payment is a set fee that the policy holder pays to providers at the time services are rendered. Co-pays are applied to emergency room visits, hospital admissions, office visits, etc. The patient should be aware of the co-payment amounts prior to the date of service. What is a deductible?Deductibles are provisions that require the policy holder to accumulate a specific amount of medical expenses before benefits are paid. For example, if your policy contains a $500 deductible, you must accumulate and pay $500 out-of-pocket before the insurance carrier will pay benefits. Once the patient has met the deductible, the carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are yearly, usually starting in January. What is co-insurance?Co-insurance is a form of cost-sharing. After your deductible has been met, the plan will begin paying a percentage of your bills. The remaining amount, known as co-insurance, is the portion due from the patient. Why did my insurance company only pay part of my bill?Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services. If you have questions about your bill, or believe that it is incorrect, call the Customer Service department at 860.837.6170, Monday – Friday from 8 am – 4:30 pm. You could also contact your insurance company for specific answers to your questions. Why do I need to call the insurance company if they do not pay the bill?The Central Billing Office will make every effort to resolve the account balance with your insurance carrier. Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance. Insurance FAQs How do I know if my health plan includes Connecticut Children's?Connecticut Children’s participates in most major health plans in Connecticut. In addition, please review your health plan provider directory and/or consult with your health plan to confirm coverage. How will Connecticut Children's know in which health plan I participate?Please present your current health plan identification card when you register for inpatient or outpatient services at Connecticut Children’s. What does "in-network" and "out-of-network" mean?If you receive your health care services from a hospital, physician or other health care provider that participates in your health plan, they are often referred to as “in-network.” Hospitals, physicians or other health care providers who do not participate in your health plan may be referred to as “out-of-network.” What should I do if my health plan includes Connecticut Children's as a participating provider, but I receive an explanation of benefits stating I used an out-of-network provider?If you have questions about your bill, or believe that it is incorrect, call the Customer Service department at 860.837.6170, Monday – Thursday from 8 am to 6 pm or Friday from 8 am to 5 pm, or you could consult your health plan. What if I have questions on my bill?If you have questions about your Connecticut Children’s bill, or feel that it is incorrect, call 860.837.6170, Monday – Friday from 8 am – 4:30 pm. Please have the patient’s name as well as the account number listed on the bill or the patient’s social security number ready when you call.