Federal guidelines can make healthcare insurance and billing complex and confusing. However, we try to streamline that process and make it as easy as possible for our patients to pay their bills. On this page you'll find answers to the common billing and insurance questions.

How does Renown's billing work?

Step 1

When you come to us for a service, we will ask you for your health insurance card and other information.

Step 2

You will be asked to pay for your portion of the estimated bill at the time of service.

Step 3

After your service or hospital stay, we will send you an informational statement. This is not a bill, but a federally required summary of your services, and it usually arrives within 30 days of your visit. Oftentimes, the amount on this statement may be different from the actual payment due.

We will contact your insurance company to collect the portion they owe. Sometimes the insurance company will not pay right away because they require more information. This might slow down payment on your account.

Step 4

If a claim is denied because the insurance company does not have enough information, we will work with you and your insurance company to get the missing information. In some cases, there is a secondary insurer, and we will work with them as well.

Step 5

After you receive the informational statement, you will be sent your actual bill that may include both inpatient and outpatient services for a specified period of time. On this bill, you may also see past due service charges.

Step 6

Once all insurance payments are received, we may ask you for additional payments for the amount not yet paid. If you are uninsured, you will receive a 30 percent discount from your total charges, with the exception of any same day self-pay price.

What will I owe?
Your out-of-pocket expense will be depends on the type of insurance you have. Typically, contacting the insurance provider directly is the best way to find out how much financial responsibility you bear. Find the scenario below that most closely matches your insurance situation for more information.

Private Insurance

Call your insurance company for the best information on your estimated out-of-pocket expenses. If you are responsible for a percentage of the charge, you can review sample charges or contact us to get an estimate of your services. If you are a member of Hometown Health, visit their website to learn more about your plan.

Medicare or a Medicare Advantage Plan

Check the CMS website for an overview of your benefits or call your insurance company for the best information on your out-of-pocket expenses. For Medicare questions, please call 775-982-4130 or 1-866-691-0284.

Medicaid

Check the Nevada Medicaid website for an overview of your benefits or contact us. For Medicaid questions, please call us at 775-982-4130 or 1-866-691-0284.

No Insurance

If you can pay your bill, you can save money by paying it within 30 days of your service. If you don’t have the means to pay your bill, we have financial counselors who can help you find assistance programs for which you qualify. To speak with a financial counselor, please call 775-982-4110.

What is your payment policy?
We work hard with every patient to arrange payment for care. However, even if you have a modest income, we expect everyone to contribute something to the cost of his or her care.

If you do not pay what you owe for your services, you eventually will be turned over to a collection agency but only after several billing notices and attempts to contact you. We are always willing to work with patients who make reasonable efforts to pay for their care.

See Billing and Collections Policy

 

Account Statements and Contact Attempts

You will receive a series of written notices for your bills in the following order:

  1. An initial statement with a summary of your charges
  2. Four attempts to contact you

These contacts will occur over a 120-day period from the first attempt to contact you.

You will always have the ability to ask us for an itemized statement or contact a customer service employee about your bill.

If you have not submitted payment or made payment arrangements with us after the four written notices, we will send your account to a collection agency. Additionally,  your account will be sent to a collection agency if you indicate at any time that you will not pay your bill or the written notices are returned due to an invalid address.

Why do I see same items on the doctor’s charges and the hospital’s charges?
When physicians provide services within a hospital service area, sometimes those charges will look the same. However, they show different services. The hospital charge is for the place of service, supplies, medications, and tests. The physician is charging for their time, evaluation, consultation, and treatment.

Why was my final charge more than my estimate?
We work closely to provide you with the best estimate we can prior to your hospital service. However, each physician will order different tests, use different supplies and medications, and may take a different amount of time in surgery for the same procedures. Your condition can also dictate that you stay a longer or shorter time in the hospital.

What is Guarantor Billing?
Guarantor Billing is a statement that combines all services for each patient into one monthly billing. Renown used to send a separate bill for every service you received and a monthly bill with a balance for each. Now each patient will receive just one monthly statement on their charges. Additionally the state of Nevada requires that we send you a summary of your charges after each service so you will see actual charges made to your account by date of service, this is an informational only statement. After that you will only receive your one monthly guarantor billing statement with the amount you are responsible to pay.

Need assistance paying for your care?
If you need assistance paying your bill, a Certified Application Counselor (CAC) will help you find coverage under the Nevada Health Insurance Exchange or determine if you qualify for Medicaid. You may also see if you qualify for any government assistance at www.coverageforall.org.

Counselors can be reached at 775-982-4110 or visit the Health Insurance Exchange website for more information.

Renown also has a the Financial Assistance Program for patients in need. Specialists are available to help you with your healthcare financial responsibilities. You must be a patient at Renown Regional Medical Center, Renown South Meadows Medical Center or Renown Skilled Nursing.

Glossary of Key Billing Terms
The following terms may help you better understand your bill and the billing process.

Adjustment

  • When your balance due has changed either up or down, both the insurance company and the hospital could adjust your balance.

Charge

  • The initial amount that a hospital gives to each service before a patient has the service.

Claim

  • A form submitted to the insurance company for payment.

Coinsurance

  • A percentage of eligible expenses that you must pay. Co-insurance usually applies after you meet your deductible.

Coordination of Benefits

  • Determining which insurance company pays first if you are covered under more than one insurance plan.

CoPay

  • When you pay a specific amount for a service, a copays is due at the time of service.

Cost

  • The amount a patient will pay after services have been completed and insurance has been applied to the amount.

Covered Services

  • Specific services or supplies that your insurance reimburses.

Deductible

  • The agreed amount of money your benefit plan requires you to pay first before they will pay. The deductible is usually an annual amount. After the deductible has been met, you will pay any eligible expenses for the rest of the year.

Dependent

  • The person you carry on your insurance. Often this is a husband, wife or child.

Disallowed Amount

  • The difference between total on the bill and the amount your insurance company covers.

Group Number

  • A health plan ID number usually found on your insurance card.

Guarantor

  • The person responsible for paying the bill.

Health Insurance Exchange

  • The place to get insurance in Nevada if you currently do not have any.

In Network

  • Doctors or hospitals participating in your health plan or insurance plan.

Insured

  • A person who has insurance.

Itemized Statement

  • A list of all items and services during your stay.

Medicaid

  • Health insurance for low or modest-income individuals.

Medicare

  • Health insurance for individuals 65+ and persons with disabilities.

Non-Covered

  • Services that are not covered by a patient’s insurance plan.

Out of Network

  • Doctors and hospitals NOT on the “preferred” list for your insurance plan.

Out of Pocket Maximum

  • The maximum amount a person needs to pay themselves.

Patient Responsibility

  • The amount the patient is expected to pay.

Preauthorization/Precertification

  • Getting advance approval from your insurance company for your services.

Price

  • The amount after services have been completed without insurance applied.

Primary Care Provider

  • Your doctor who coordinates your care.

Primary Insurance

  • The insurance company with first responsibility for paying eligible health expenses.

Provider

  • A healthcare professional (doctor or nurse practitioner) or facility (such as a hospital or clinic).

Secondary Insurance

  • The insurance company with second responsibility for paying eligible health expenses.

Subscriber

  • The person who purchased the insurance.

Visit Number

  • The unique number assigned to each visit.