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Billing Information
Frequently Asked Questions
Glossary of Terms
Sample Bill
Frequently Asked Questions
Who and when can I call regarding my clinic bill?
For questions regarding your clinic (red) bill, please call 641.621.2241 during the hours of 8:30 a.m. and 5 p.m. Monday through Thursday and 8 a.m. and 4:30 p.m. on Fridays.
Who and when can I call regarding my hospital bill?
For questions regarding your Hospital (blue) bill please call 641.628.6692 or 641.621.2305 during the hours of 7 a.m. and 5 p.m., Monday through Thursday and 7 a.m. and 4:30 p.m. on Fridays.
Will the hospital and clinic bill my primary and secondary insurance?
Yes. As a courtesy to you, Pella Regional Health Center (PRHC) and Pella Medical Clinic (PMC) will submit bills to all of your insurance companies. You will need to provide us with complete, accurate information on all insurances. Please be sure to bring your most recent copy of your insurance card with you. Some insurance companies require additional information from the patient before they will process a claim. In this instance, it may be necessary for you to contact your insurance company and provide them with that information. If you do not contact them with the requested information, your claim will be denied and you will be responsible for these charges.
Why did I receive two statements?
Services for the clinic and hospital appear on separate statements. The clinic charges (including charges from our rural health clinics) are billed on the red statement. The hospital’s facility charges are billed on the blue statement. If you were seen in Urgent Care or Emergency, the charges for the physician that examined you are billed on the red bill for the clinic. The charges for the room and any other tests, medications or supplies are billed on the blue hospital statement.
Why are my labs being billed as outpatient services on the hospital bill?
Charges are billed by the lab that provided the service. If your lab was drawn in the clinic, the drawing fee will be billed on your clinic statement, and the charges for the lab tests will be billed on your hospital statement. If the tests were sent out to an out-of-town facility, you will be billed directly by that facility.
When I receive two bills, do I need to send two separate checks?
Yes. Our accounting systems are separate. To ensure your account is credited properly, you will need to send a check with each statement. Please be sure to include the top tear-off portion of each statement with your check to make sure your payment is credited to the correct account.
Will I receive an itemized statement for hospital services?
The first statement you receive after a visit will be itemized. Any subsequent statements will be a summary. If you would like another itemized statement, please call 641-628-3150, between 7 a.m.-5 p.m. Monday through Thursday and 7 a.m.-4:30 p.m. Friday.
Do you offer payment plans?
Payment in full is due upon receipt of either a red clinic or blue hospital bill. If you are unable to pay in full, please contact the Business Office at 641.621.2328 or 641.621.2305 to discuss payment arrangements.
Can healthcare facilities turn my account over to a collection agency?
Yes. If payment is not made in full, or an agreeable payment arrangement is not set up within 25 days from the date on the first statement, the account is considered delinquent. Collection action may be taken on accounts over 25 days old.
Is there assistance if I can’t pay my bill?
Yes. Pella Regional Health Center is a not-for-profit corporation, which fulfills its charitable purpose by providing health care services to the Pella Community and surrounding areas. Pella Regional Health Center has established a Charity Care program to assist patients with financial obligations. This program will consider a reduction of uncovered medical expenses for patients. Assistance for this program is “needs based” and is not an entitlement program. It is the applicants’ responsibility to provide the appropriate documentation for consideration. Forms are available from the Business Office.
I stayed overnight in the hospital. Why is this billed as an outpatient stay?
The physician who ordered your service determined that your condition did not meet the criteria for an inpatient admission. The physician's written order determines if we bill as an inpatient or an outpatient.
Medicare and my supplement always pay my bill in full. Why do I have a balance due?
Medicare will not pay for self-administered drugs given to a patient on an outpatient basis. If you were in the emergency room or were an observation patient, you may be required to pay for drugs that Medicare determines are self-administered. Medicare also has medical necessity checks on certain outpatient tests. If Medicare has determined your test to be not medically necessary, you will be required to sign an Advanced Beneficiary Notice prior to the test being performed. The charge for the test(s) will then be your responsibility.
Must I register each time I come to the hospital?
Yes. We are required to submit a separate bill each time you present for services. We ask that you verify the following information each time you check-in: name, date of birth, social security number, address, phone number, alternate phone number, person to notify, employer and insurance information. If you are interested, you may pre-register online by clicking here
Must I show my insurance card(s) each time I present for services?
Yes. We require a copy of your most recent insurance card(s) each time you present for service to ensure that we are billing the correct insurance company. Insurance information can change from month to month, so it is important that we have a copy for correct claims filing information.
Why should I contact my insurance company if they do not pay my bill?
Patient Accounts will make every effort to resolve your account with your insurance company. Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance.
How do I know if my health plan requires a referral or pre-authorization for a service?
It is your responsibility to contact your insurance company to find out if a pre-authorization is needed. Your benefit book or provider directory should provide this for you. We recommend to contact your insurance company prior to any procedure to verify whether a referral or pre-authorization is needed. Not doing so could be costly.
Glossary of Terms
For a complete listing of terminology used in this and in other related documents, please visit the Centers for Medicare & Medicaid Services website at www.cms.gov and click on the “glossary” link.
Sample Bill
Clinic Bill
A: Credit Cards that we currently accept for payments. We also accept checks.
B: This is the amount that is currently due.
C: This is your statement number. Please reference on your check.
D: Name of the Guarantor—who the billed is mailed to.
E: Name of the Patient who received care. This might not be the
same as the Guarantor.
F: This is the amount due
G: Informational Message
Hospital Bill
A: Credit Cards that we currently accept for payments. We also accept checks.
B: This is the amount that is currently due.
C: This is your account number. Please reference on your check.
D: Name of the Guarantor—who the billed is mailed to.
E: Name of the Patient who received care. This might not be the
same as the Guarantor.
F: This is the amount due
G: Amount due if you’ve arranged a contract with the Business Office.
H: Informational Message
Long Term Care Bill
A: Credit Cards that we currently accept for payments. We also accept checks.
B: This is the amount that is currently due.
C: This is your account number. Please reference on your check.
D: Name of the Guarantor—who the billed is mailed to.
E: Name of the Resident who received care. This does might not be
the same as the Guarantor.
F: This is the amount due
G: Informational Message
