Frequently Asked Billing Questions

Borgess is committed to providing quality health care service to all patients.

To continue in this mission, it is essential that payments be received for services provided. As a courtesy to our patients and their families, Borgess will submit your bill to your insurance company according to the listed guidelines. To do this efficiently, it is important that accurate and complete insurance information be presented at the time of registration.

The following are answers to frequently asked questions about billing and payment for health care services at Borgess Medical Center, Borgess at Woodbridge Hills, Borgess-Pipp Hospital, and Borgess-Lee Memorial Hospital.

  • How do I find out estimated charges for a procedure to be performed at Borgess?
    For pricing information on inpatient and outpatient services, call Borgess Patient Financial Services at (269) 226.8494 from Monday through Friday, 8 am to 4:30 pm. Operators will need available insurance information to provide the most accurate estimate.
  • Does Borgess participate with my health plan?
    If Borgess "participates" with your health plan, that means that the hospital has an agreement with your insurance company to provide services for its members. You should check with your health plan to verify that the hospital, physician practice and care providers participate with your plan.
  • When am I responsible for obtaining approval from my health plan prior to receiving services?
    Depending on your insurance plan, you may be required to contact your primary care physician or health plan for approval prior to receiving services. If your situation is truly an emergency (life-threatening), you or a family member must contact your physician or health plan within 24 hours of receiving treatment. If you do not obtain health plan approval, all hospital charges may become your responsibility. While insurance companies cover Emergency Room charges for true emergencies (life-threatening situations) and many outpatient services, coverage differs. Your insurance company may require you to pay for emergency and urgent care services determined to be non-emergent, (non-life-threatening).
  • What if the hospital doesn’t participate with my plan?
    Even if Borgess does not participate with your health plan, you may still receive services at Borgess. However, you should know that these services are considered "out-of-network" and may not be covered. You are responsible for paying the bill in full or for any balance not paid by your health plan. As a courtesy, we initially bill non-participating health plans. However, you are responsible for payment if the plan does not promptly respond to the claim.
  • Will you bill my insurance company?
    Borgess will directly bill your insurance company and send you a statement after receiving the plan’s determination of the amount covered. Depending upon the services provided, if your insurance plan requires payment of a co-pay and/or deductible, you may be requested to pay this amount at the time of service. Immediate payment enables Borgess to contain billing costs. If your insurance company has not responded to the claim within 45 days, you are responsible for assisting in obtaining payment from the insurance company.
  • Why aren’t my doctor’s charges included on my hospital bill?
    As most physicians, radiologists, pathologists, anesthesiologists and emergency room physicians are not employed by Borgess, you (or your insurance company) may receive a separate bill for physician services. This separate physician billing practice is customary.
  • What are Medicare and CHAMPUS patient rights?
    Borgess is required by the U.S. government to provide Medicare and CHAMPUS patients with specific information regarding their patient rights. If you have not received this information during your current hospital stay, please ask to speak to your unit’s Care Manager or call (269) 226.8311.
  • How do I make a payment?
    Patients may pay by check, money order, cash or credit card. Borgess accepts Visa, Mastercard, Discover, American Express and eCheck online here. If you cannot pay your bill in full at the time of service or at the receipt of your first bill, patient financial counselors are available to assist with billing questions and provide information regarding other possible payment options from 8 a.m. to 5 p.m., Monday – Friday. To learn more, please call (269) 226.7281 or (800) 944.3345.
  • My explanation of benefits (EOB) says I am not responsible for the usual and customary or reasonable and customary fees. What does this mean?
    While your insurance provider may state that you are not responsible for these charges, Borgess does not recognize reasonable and customary or usual and customary fees as a discount. Many charges may vary from one payor to another. Some charges are higher and some are lower. None of these factors justify charge reduction. Therefore, you are responsible for these charges.
  • Why am I just now getting a bill for services I received quite some time ago?
    We regret the delay and any inconvenience we have caused. However, Borgess must first work with various insurances to process claims and receive their payments before billing patients for the remainder of the balance.
  • Why am I receiving a bill for the total amount of my visit? Haven’t you billed my insurance company?
    Borgess submits bills to insurance companies according to the listed guidelines. After receiving the plan’s determination of the amount to be covered, Borgess then sends statements to patients. Depending upon the services provided or if the insurance plan requires payment of a co-pay and/or deductible, patients may be requested to pay this amount at the time of service. Immediate payment enables Borgess to contain billing costs. If your insurance company has not responded to the claim within 45 days, you are responsible for assisting in obtaining payment from the insurance company.
  • How can I request a total itemization of my account with Borgess?
    You can request an itemized statement online here or through our automated telephone system by calling (269) 226.7281 or toll-free at (800) 944.3345. When prompted, you will need to verify your name, account number, address and daytime telephone number. Your itemized statement will then be printed and mailed to you within 48 hours.
  • Why am I receiving statements for an account I paid?
    Your statement may have been sent just prior to your payment, or we may have not processed your payment before your statement was sent. If you have recently sent in payment for the account listed on the billing statement, please disregard the statement.

Do you have questions that we have not answered here?
Please feel free to contact us at any time.

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