Billing, insurance and pricing FAQs

Your insurance plan may require you to obtain approval from your primary care physician or health plan prior to receiving the services. You should always check with your health insurance carrier prior to the service. If the situation is an emergency or life threatening, you or a family member may contact your physician or health plan within 24 hours of the visit. If the visit is determined to be non-emergent or not life threatening, you may be required to pay for the service yourself.

Your insurance card contains valuable billing information. We use this information to help ensure accurate billing to the correct payer. Your card also indicates any co-payments that you may owe for the visit. Please review this information prior to your visit. If there are any billing issues that arise, we will have your insurance information at our fingertips to help resolve the problems.

Yes. If you are utilizing one of our clinical offices, you should pay your co-pay when you register. Your co-pay amount should be indicated on your insurance card. You should direct any questions regarding your co-pay to your insurance company.

Our offices will accept payment in the form of credit or debit card. We do not accept cash or personal checks.

If patients are unable to pay at the time of the visit because they do not have a credit or debit card available, they will be billed as they are today and can submit a payment via mail using check, credit, or debit card. For Lancaster General Hospital patients, cash payments will be accepted at the Customer Service Walk-in Office located within the Patient Resource Center in the main hospital lobby at the James Street entrance.

Your statement may have been sent just prior to the processing of your payment. The statement may be for a different account. Verify that the account number is the same as the account number of the account that you paid.

If you receive more than one statement after paying an account, please verify that your check was cashed. If it was cashed, ask your bank when it cleared your account. This information will be very helpful to the customer service specialist that will be researching your payment.

If you do not place an account number on your check and we did not receive the statement stub indicating the account number with the check, your payment will be posted to the oldest account balance in our billing system. This may not be the account for which you are receiving the statement.

For information about your bill, please call the number listed on your bill.

If you have other billing-related questions, want information on payment options, or if you do not have your bill, please call the following:

• Penn Medicine locations in Philadelphia and Chester County Hospital: 800-406-1177
• Lancaster General Hospital or Lancaster General Health Physicians: 717-544-4953 or 800-647-4419
• Princeton Medical Center: 609-620-8300

In certain cases, you may be protected from balance billing and surprise medical bills. In these cases, we can’t charge you more than your plan’s out-of-pocket costs.

If you have an emergency medical condition and get emergency services from an out-of- network provider or facility:

• We can bill you your plan’s in-network cost-sharing amount. This includes copayments, coinsurance, and deductibles.
• We can’t balance bill you for these emergency services. This includes services you may get after you’re in stable condition (unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services).

When you get services from an in-network hospital or ambulatory surgical center, certain providers may be out-of-network.

For emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services:

• We can bill you your plan’s in-network cost-sharing amount.
• We can’t balance bill you. We may not ask you to give up your protections not to be balance billed. If you get other types of services: We can’t balance bill you, unless you give written consent and give up your protections.

To learn more about your rights under federal law: Visit Cms.gov/NoSurprises for more information about your rights under federal law or call 1-800-985-3059.

Lancaster General Health tries to maintain contractual relations with carriers that represent the highest volume of Lancaster County employers/residents. It’s not feasible to have contracts with every carrier. We recommend you contact your insurance carrier and ask about participating providers.

To “participate” with a health plan, means that Lancaster General Hospital has a contractual agreement with the health plan. It is the patient’s responsibility to contact their health plan to verify that the hospital, physician practice, and other health care providers participate.

Lancaster General Hospital is committed to providing high quality service from the point of registration through the billing after the service. Many of our customers have a change in insurance plans on a regular basis. This happens for a variety of reasons such as a job change, an employer changes carriers, or the customer chooses a different plan to meet their health care needs. Often patients think that if they have given their insurance information to their doctor or another provider, we have access to this information. This is more often than not an incorrect assumption. Our goal is to get it right the first time so that the customer does not receive a bill in error. The few extra minutes it takes to verify that we have the correct insurance information at every visit can save the customer time down the road.

Usual and customary or reasonable and customary rates are terms insurance companies use to define what they determine to be the going rate in a particular area. These rates may vary from payer to payer. Lancaster General Hospital does not accept these rates as payment in full. Many charges may vary from one provider to another, some higher and some lower. You will be responsible for the balance of these charges.

Your insurance company is responsible for sending you an explanation of benefits regarding any payments they make toward your bill. It should also indicate any liability you have regarding the claim. If you have questions about your explanation of benefits, call your insurance company. The explanation of benefits should be kept as a reference tool for any balance due notices you may receive from Lancaster General Health.

If you owe a deductible, co-payment, co-insurance or non-covered charge for a service, Lancaster General Hospital’s billing system will generate a statement for the balance due. This is not a detail bill of your account. If you would like a detailed bill you may contact Customer Service at 717-544-4953 or 1-800-647-4419.

If your insurance company pays the bill in full, you will not receive any additional bill from Lancaster General Hospital.

To prepare for the call with your insurance company have the following items available:

• Your insurance card
• A copy of your EOB
• Pen and paper to document your call

Take the name of the person to whom you are talking. Ask the status of the claim. If paid, ask them who the check was made out to, the check number, date of the check and amount. Get the phone number of the person you are talking with.

If the claim has not been paid, ask for the anticipated payment date. Ask if they have all the information to process the claim. If they need additional information, obtain a fax number. The fax number and a contact person are very useful for the Customer Service Department.

Once you have the information you need from the insurance company, contact Lancaster General Hospital’s Customer Service department at 717-544-4953 or 800-647-4419 to provide the information you have gathered.

Lancaster General Health will bill most insurance plans. Our customers are responsible for submitting claims to any liability insurance companies such as homeowners and school insurance directly. Our Medicare patients are responsible for submitting any co-insurance amount on their professional component to their supplemental carrier unless the carrier receives crossover information from HGSA. If we bill a secondary payer, the customer is responsible for submitting a copy of their explanation of benefits from the primary payer to the secondary payer. The patient will ultimately be held responsible for payment of all services provided, unless Lancaster General Health is restricted by a contractual arrangement or federal or state regulations.

Lancaster General Health generates an account number each time a service is provided. Generating a different number for every date of service simplifies the billing process and helps our customer service department help you with your questions regarding different services provided. Lancaster General Health does bill certain on-going services such as physical therapy, radiation therapy and occupational therapy with the same account number often for the duration of the service. These accounts bill monthly for all charges entered during that month. An inpatient hospital stay will generally have one account number.

In addition to Lancaster General Health’s charges, you may also receive a bill for physician charges such as the emergency room physicians and radiologists that read your x-rays. These physicians work independently and will bill separately.

Lancaster General Health does not have access to other providers’ billing systems and will not be able to assist you with these bills.

Lancaster General Health will bill the patient for non-covered services. You may receive a bill that indicates you are responsible for the total amount of the charges for a variety of reasons:

• We may not have your insurance information
• We may have billed your insurance company and they may have denied the service
• We may have billed your insurance company and they are requesting information from you

You are legally responsible for your bill at the time the service is provided. You are ultimately responsible for ensuring the system is reimbursed for the services provided to you. Lancaster General Health will use the information provided by you to submit your claim for payment. Under Act 68, your insurance company is required to act in your best interest by processing your claim for payment or denial within 45 days of receipt of the bill.

We regret any delay and inconvenience that this may cause you. However, Lancaster General Health does its best to work with the various insurance payers to receive payment prior to billing you.

Lancaster General Health accepts cash, money orders, checks, and credit cards (Visa, Mastercard and Discover)

If you are unable to pay the full balance in one payment, we offer the following terms:

If the balance is less than $1000, the customer can split the payment into a maximum of 6 equal monthly installments.

If the balance is $1000 or higher, we can arrange a maximum of 12 equal monthly installments.

Lancaster General Health also offers a financial assistance program for uninsured and underinsured patients. This program is based on income and assets. To discuss your options and obtain a copy of the financial assistance application, please see one of our financial counselors located at the hospital, Suburban Pavilion, and Women & Babies Hospital. or contact the Financial Assistance Department at 717-544-1957.

Lancaster General Health also offers a self-pay discount for any medically necessary services provided to any patient without insurance coverage.

You can request a detailed itemized statement by calling 717-544-4953 or 800-647-4419.

You can mail a check, money order, or credit card information using the envelope that came with your bill. If not using the envelope, the mailing address is:

Lancaster General Hospital
Attn: Cashiers
PO Box 3555
Lancaster, PA 17604

Be sure to write your account number on your check or money order.

You can make a credit card payment through our phone system 7 days a week, 24 hours a day by calling 717-544-4953 or 800-647-4419.

Lancaster General Hospital accepts Visa, Mastercard and Discover.

The operating hours for the customer service department are:

Monday – Thursday: 8:30 am – 5:30 pm
Friday: 8:30 am – 4:30 pm

You can pay in person at Patient Financial Services walk-in located on the first floor of Lancaster General Hospital Monday through Friday 8 am – 4:30 pm.

You can pay online using MyLGHealth.