FAQs

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You may have questions about your financial responsibility and what exactly your insurance may cover. Below are the most common questions patients ask about their insurance coverage and clear, simple answers to them. By giving you a summary of your financial rights and responsibilities, we hope you can concentrate on the most important part of your hospital stay ... getting better.
Insurance Coverage and Payment

You may have questions about your financial responsibility and what exactly your insurance may cover. Below are the most common questions patients ask about their insurance coverage and clear, simple answers to them. By giving you a summary of your financial rights and responsibilities, we hope you can concentrate on the most important part of your hospital stay ... getting better.

 

Banner did recently switch statement partners, which means your statement looks different and contains updated information. Learn more.

If your statement is from a hospital visit or a visit to select outpatient centers or physician offices, this document should help guide you through your statement.

Yes, Banner partners with a company that offers a "Patient Concierge," which is a virtual assistant who digitally walks a patient through the different components of their bill. This service is available on any statement that has a QR code printed on it. Learn more.

Each statement you receive should have an online pay option listed. You may also visit our online bill pay site for payment options. 

If you have questions regarding your bill, our billing experts are here to assist you. 

If you received a bill from Banner, you will note that there is a customer service information provided directly on the bill. If you have been discharged from the hospital and you have financial questions but have not received a bill, please contact one of our billing experts for assistance. They can be reached at (888) 264-2127 Monday through Thursday 8 a.m. - 7 p.m.; Friday 8 a.m. - 5 p.m.; Saturday 8 a.m. - 12 p.m. (all times are MST). 

Since every insurance plan is different, it is always best to check your coverage and ask questions. We recommend you know the benefits of your individual plan, which have designations for preferred providers, in-network care and out-of-network care. Not following your insurance company's rules could result in a larger financial responsibility for you. 

Your insurance plan can deny payment for services or procedures even after they have been completed. Many health maintenance organizations (HMOs) and insurance plans now require pre-admission notification, approval or second opinions for certain procedures. We recommend you contact your insurance plan directly or contact your employer (as applicable) for more information. 

Yes. Your insurance card contains information we need to file a claim with your insurance on your behalf. Your registration process goes much faster when you bring your insurance information with you.

You are expected to pay your plan-required co-payment, estimated co-payment and/or deductible at the time of service. Banner accepts cash, personal checks, and credit cards. 

We have additional resources on our Financial Assistance page to assist you, including information about the insurance marketplace. Patient Financial Representatives in the Business Office can also discuss payment arrangements with you.

Many insurance companies have special reimbursement rules regarding Emergency Care. These rules may require patients to receive care at the appropriate level, meaning at an urgent care facility or physician office rather than via an emergency room. Not being familiar with these guidelines could result in a greater financial responsibility for you. Please refer to your insurance company plan guidelines to determine what level of care you would like to use. 

Yes, the hospital will send your insurance company a bill for services you incurred as a patient. It is important to remember, however, that the hospital relies on you for settling your account in full regardless of your insurance coverage. Your insurance policy is an agreement between you and your health insurance provider. 

When a charge is denied by an insurance company, the reason will be indicated on your Explanation of Benefits (EOB) document, which is sent by the insurance company. If the denial reason is noted as "provider responsibility," Banner will escalate that denial to our internal appeals department, and we are able to work with your insurance company to appeal the denial. If the denial reason is noted as "patient responsibility," Banner can unfortunately not appeal that decision; you will need to work with your insurance company to understand the denial reason more.

Please contact Banner if you feel your insurance denied the claim incorrectly and we will be happy to re-validate our coding. However, please understand that providers must follow billing guidelines and we cannot change diagnosis or procedure codes for the sole purpose of reimbursement.

It is our commitment to ensure patients are billed only for the services performed and have many safeguards in place to ensure billing accuracy. That said, Banner has a team of nurses that will perform a full audit on your account upon request. If any discrepancies are found, charges will be removed or added to your account, after which Banner will send a corrected claim to your insurance provider. Depending on how the original claim was paid and your insurance benefits, a change in total charges may or may not result in a change in your patient responsibility.

It is very important to respond to any inquiries from your insurance company regarding coverage details, such as details of an accident or other incidents, even if you feel coverage does not exist. If insurance companies do not receive a response to an inquiry, the claim is denied to patient responsibility. If this occurs, patients must call their insurance to provide additional information or annual coverage updates prior to contacting Banner. Insurance companies will then reprocess the claim and issue payment, but typically only if they receive a response in a timely manner.

Not necessarily. You may get separate bills for medical services performed by other contracted professional medical personnel when you receive care at Banner. While they may work at the hospital, they may not actually work for the hospital, such as emergency physicians, radiologists, pathologists and anesthesiologists. You will receive separate bills for this care, which will include customer service information for any specific billing questions you may have.

Banner Health partners with multiple organizations which help thousands of people find programs to assist in finding coverage and additional benefits, which may help pay for some costs of prescription drugs, health care, utilities, and other essential items or services. Visit our Financial Assistance page to find out more information about these programs. 

  • Benefit – Coverage offered by an insurance company or other organization
  • Co-payment – The portion of your bill you are required to pay for during registration. Co-payment amounts vary depending on your insurance policy.
  • Deductible – The amount your insurance company determines you must pay before they begin dispensing benefits on services rendered.
  • Insurance Claim – The bill for services the hospital submits to your insurance company or companies.
  • Itemized bill – A list of individual charges for services and procedures you received during your hospital stay. Also lists your account number.
  • Patient Balance – The amount on your bill that you need to pay.
  • Statement of Account – Shows any activity (for example, insurance payments or denials) that has occurred since the itemized bill was sent.