Billing & Financial Assistance - UChicago Medicine (2024)

For patients with health insurance, once your insurance company has been billed and has responded to us, we determine how much you may owe and bill you.

Payment is due upon receipt. If your insurance company does not pay within 90 days of receiving a bill from the UChicago Medicine, you may receive a statement showing that your insurance company has not paid the bill.Bills can be sent up to 12 months from the date of service or six months from when we receive the explanation of benefits (EOB) from your insurance provider.

Whether you have insurance coverage or not, you as the patient are ultimately responsible to make sure your bill is paid. If you receive a statement showing that your insurance company has not paid, it may be helpful for you to contact your insurance company to ask why payment has not been made.

As a patient, it is in your best interest to know and understand your insurance plan benefits and your responsibility for any deductibles, co-insurance or co-payment amounts prior to any visit. Not all services are covered in all insurance contracts. If your insurance plan does not cover a service or procedure, you may be liable for full payment of the bill.

To find out what your insurance plan covers and what your financial obligation may be, call the Customer Service or Member Services Department of your insurance company (the phone numbers are on your insurance card). Your employer's human resources department may also be a source of information and assistance.

It is important to understand your insurance plan’s current benefit and coverage rules. Policies and coverage determinations may vary from year to year. Please be aware that our outpatient visits are billed as “hospital-based outpatient clinics” and not private doctor office visits. Some insurance plans pay different benefit levels for each type of visit. You should also check that your insurance company lists both your physician and hospital as participating providers. It is possible that only the physician or the hospital participates with your insurance plan. If you have services provided by an out-of-network provider, you may be at risk for a greater out-of-pocket financial responsibility.

If you do not see your physician and/or hospital listed as contracted with your health plan or you have any other insurance questions or concerns, contact the UChicago Medicine’s Office of Managed Care by email atOPSFinancialCounseling@uchospitals.eduor see our list of contracted insurance plans.

If your insurance company requires a referral and/or prior authorization, contact your primary care physician prior to seeing a specialist.

If your insurance company requires a referral and you do not have one, you will be responsible for full payment of your bill at the time of service, or you may not be seen for your scheduled appointment. If your specialist requires more visits or tests than your insurer approves or if the referral has expired, you must contact your primary care physician for another referral and/or prior authorization.