1. Is the
physician's office, hospital or other provider a contracted network
provider for your insurance? Check at both ends. Most insurors usually
pay a lower share of the bill when you use out-of-network providers
- meaning that you are obligated to pay more from your pocket. If your
insurance plan isn't on the following list, call our Managed Care Director
at (317) 736-2681.
2. Full insuror
payment often depends on pre-certification being on record for referrals
to specialist physicians, hospital inpatient admissions, diagnostic
or therapy services, home care, etc. Normally the referring physician
will get this pre-certification, but protect your pocketbook - ask for
a record of the pre-certification.
3. Even when
a hospital is a network provider for your insurance plan, this may not
be true for the hospital-based physicians involved in your care - the
radiologists who read your x-rays, CT or MRI; emergency physicians;
pathologist who supervises your lab work; and others. You may receive a separate bill from these physicians or physician groups.
Many insurance companies offer different insurance programs. JMH may or may not be "in network" with each program. It is important to make sure that JMH is “in-network” with not only your insurance provider, but also the specific insurance program/plan.