A Family's Guide to Billing at Children's

No matter where your child is treated at Children's, you can expect to receive bills from the hospital as well as separate bills from doctors for their professional services. Usually, more than one doctor will care for your child. So, you may receive several doctor bills (attending doctor, surgeon, radiologist, pathologist, etc.). Depending on the type of visit you have at the hospital, you may also receive separate bills for charges such as lab tests or certain supplies.

If you have insurance:

The doctors who treat patients at Children's are not employed by the hospital. Many doctors are contracted with the same insurance plans as the hospital. However, some doctors (such as emergency room doctors, anesthesiologists and surgeons) may not have the same contracts. Please contact your insurance company to verify if the doctor treating your child is in your plan's network.

Outpatient Specialty Clinics

You will need a referral from your primary care doctor for your child to be treated in one of the Children's specialty clinics.

Lab, radiology and pharmacy

The doctors who treat children in the hospital are highly trained to be the best equipped to handle complex care. The doctors will bill their professional fees, and you will be asked to pay the doctor co-pay required by your health plan. This physician co-pay will not include lab tests, radiology and pharmacy. Children's will bill separately for those services. These charges may be applied to your outpatient deductible.

The hospital will bill for any radiology, lab services or pharmacy provided during the visit. You will be asked to pay for any portion of these charges that are applied to your health plan's outpatient deductible or co-insurance.

Children's labs services are specialized for pediatrics; however, not all insurance plans recognize Children's as a preferred provider for lab services. You may be charged an extra out of pocket expense. If you chose another lab for tests that is in-network with your plan, Children's will be happy to help you find the center most convenient for you.

Emergency Room, First Care, Referral Care Center

The doctors treating patients in the Emergency Room, First Care and the Referral Care Center all will send their own bills for their professional services. The hospital will bill for the facility charges. Not all emergency room physicians will be in the same contracted networks as the hospital.

Emergency Room co-pays will be due in the Emergency Room and First Care.

Urgent Care co-pays will be due in the Referral Care Center.

The doctors, radiologists and pathologists will bill their professional fees.

Admission, Day Surgery, Radiology, Therapy or Lab Services

You will be asked to pay any co-pays, co-insurance or deductibles for the services provided by the hospital. These services may require authorization. Contact your insurance company to better understand your plan's requirements.

If your child is admitted to an inpatient bed for a short stay, the physician may order "observation" services instead of "inpatient" based on the child's medical condition. If that is the case, these services will be billed as "outpatient" services instead of inpatient and will be subject to your plan's outpatient deductible requirements.

The doctors, surgeons, radiologists, anesthesiologists and pathologists will bill the professional fees.

IF YOU DO NOT HAVE INSURANCE:

Many of our patient families are surprised to learn that their child qualifies for assistance. You can speak to a financial counselor in the Admitting office, or you call a financial counselor at 214-456-8640 weekdays from 7 a.m. to 10 p.m. or weekends from 7 a.m. to 5 p.m.

If you earn too much to qualify for assistance, you may be eligible for a prompt-pay discount. Please call Customer Service for this information at 214-456-BILL (2455), Monday-Friday from 7 a.m. to 7 p.m.

IF YOU HAVE ANY QUESTIONS CALL 214-456-BILL (214-456-2455) OR
EMAIL: patientbilling@childrens.com