Who can I contact to get a cost estimate for an upcoming procedure?
You can contact a customer care representative at (757) 233-4889 between 8:30 a.m. and 4 p.m., Monday through Friday. When I call for a pricing estimate, what information do I need to have available?
To receive the most accurate estimate possible, please have the following items available:
- Copy of current insurance card
- Current deductible or HRA/HSA bridge/gap information
- Current co-payment and/or co-insurance amounts
- Name of facility where your doctor will perform the procedure
- Procedure code
- Name of surgeon, referring physician and office phone number
- Information on whether the procedure will be inpatient or outpatient.
If needed, please contact your insurance provider to obtain this information. You may also want to contact your health insurance provider to verify your benefits.
If you will be a self-pay patient or do not have valid insurance information available, you may be prompted to participate in our financial assistance programs
. How is a charge set for my services?
The charge for services is based on many factors that vary from hospital to hospital. These factors include:
- purchasing medications, surgical equipment, up- to-date medical technology and other supplies
- powering and maintaining hospital buildings
- paying health care workers
The charges will be based on the average number of procedures performed and the average total charges for those procedures, using current data base information.
Charges are usually revised on an annual basis. These changes are made at the beginning of our fiscal year, which starts January 1. However, as technology and resources change, we may update our charges at other times during the fiscal year. Will I be able to receive a price quote based on my insurance plan or do I need to contact my insurance plan for specifics?
You should be able to receive a price quote based on your insurance plan information and the requested information listed above.
You may also want to contact your health insurance provider to verify your benefits and possibly receive an estimate from them, as well. Will the price I receive be guaranteed or will it be a range or estimate?
It is an estimate based on the information you provide and your responses to the questions listed above, as well as your insurance benefits at the time of your inquiry.
This estimate does not include physician fees or charges for any additional tests ordered for your care. The estimated amount is not a guarantee of the amount you would owe. Your final bill will include charges for the actual services provided to you.
In addition, the estimated amount you may owe is not a guarantee of insurance coverage. Please consult with your insurance company if you have any question regarding the scope of your insurance coverage.Will the price reflect all aspects of my care whether inpatient or outpatient?
The estimated amount you will owe does not include any physician charges (including, but not limited to office visits, surgeon, anesthesiologist, emergency room physician, radiologist, pathologist, consulting physician, etc.). If you have requested an estimate for a surgical procedure, this estimate does not include pre-procedure office visits, post-procedure office visits and diagnostic testing. Will the price also show my out-of-pocket expenses?
Yes. You will receive an estimate based on the insurance you selected and your responses to the questions. Our estimate will provide the information similar to the following example:
*This estimate reflects averages charges, which are based on the number of cases and total charges over a period of time.
Type of Service:
Health Plan XYZ
|Average Hospital Charges:
|Estimate of how much you owe***
** The amount you may be required to pay for services after you pay any plan deductibles.
*** See prior answers for information on what services may not be included in the estimate.
If my insurance company has pre-certification, prior approval or notification requirements for specific services am I responsible for taking care of this?
The specific requirements and responsibility for completing pre-certification or notification depend on several things, including the contract agreements between Sentara Healthcare and your insurance company and the requirements defined by your insurance or employer group plan. In many cases, Sentara Healthcare can assist with these requirements if we have a contract with your company.
However, if you have questions about your responsibility for completing these requirements, you should contact your insurance company directly. You may have to pay a higher deductible or co-insurance amount if these steps are not completed.
What are Sentara's policies if I do not have health insurance?
Sentara participates in a number of financial assistance programs to help patients resolve financial difficulties