Who and when can I call regarding my clinic bill?
For questions regarding a bill, please call 641-628-6700 during the hours of 6:30 am – 5 pm, Monday through Friday.
How does Pella Regional Health Center set their prices?
Pella Regional Health Center has a market based approach to setting prices. Periodically, an independent 3rd party is engaged to conduct market research to ensure our prices are reasonable compared to our market place. Prices of some services are adjusted at the conclusion of those studies. For new services, a market based approach is also used. We set the prices of new services to be consistent with other providers in our Central Iowa marketplace.
Will the hospital and clinic bill my primary and secondary insurance?
Yes. As a courtesy to you, we 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 the most recent copy of your insurance card with you.
Some insurance companies require additional information from the patient before they 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 payment.
Why did I receive two statements?
Services for the clinic and hospital now appear on one statement. Prior to November 1, 2017, the clinic charges (including charges from our clinics outside of Pella) were billed on a red statement. If you still have clinic charges prior to this date, you will continue to be billed on the red statement.
Why are my labs being billed as outpatient services on the hospital bill?
Services like lab, medical imaging, therapies, wound care, and cardiac rehab are provided by outpatient departments of the hospital and thus are billed on a hospital statement and subject to co-insurance rather than co-pays. If you are unsure what the costs of these services may mean for you, please contact our Pre-Services team at 641-628-6700 and they can assist with providing an estimation of your potential cost.
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 statements following that will be a summary. If you would like another itemized statement, please call 641-628-6700 between the hours of 6:30 am – 5 pm, Monday through Friday.
Why am I being asked to pre-pay for my surgical procedure?
Starting the cost conversation early is important because most insurance policies today have significantly higher co-pays and deductibles resulting in larger out-of-pocket expenses for you. Pella Regional is attempting to minimize the after-service surprise by providing an estimate and asking for pre-payment based on your specific insurance situation and your doctor's recommended procedure. Staff has found that patients prefer to be informed of their choices up front and those who pay in advance have less to worry about with billing as they recover.
Is there financial assistance if I can’t pay my bill?
Yes. We understand and respect the stress and strain that is created by medical bills. Pella Regional can provide financial assistance to individuals who qualify. Support is based on need, and eligibility must be demonstrated.
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 stay.
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 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 come to the clinics or hospital for services.
Must I show my insurance card(s) each time I come in for services?
Yes. We require a copy of your most recent insurance card(s) each time you are 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 you contact your insurance company prior to any procedure to verify whether a referral or pre-authorization is needed.