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Patient Financial Responsibilities

It's important for you to know the terms of your health insurance policy. Please inform us if your insurance and/or policy changes.

What should you bring when you come to the hospital?

Please provide insurance information, personal identification, medication information, and demographic information. If you have been here before, we will review the information in your medical record to ensure your information is current and correct.

Contact Information

For questions and assistance regarding your bill, call 855-827-3633.

Check List

We recommend you have the following items with you at the time of registration or while in our Emergency Room:

✔ A valid form of identification, i.e., driver’s license, birth certificate, passport, State ID, visa.

✔ Current address and telephone numbers.

✔ Name, addresses and phone numbers of family members or friends to contact in an emergency.

✔ Insurance Cards. If you have more than one policy, bring ALL of your insurance cards. These cards contain information that allows doctors and our hospital to bill the correct address for your insurance company. Your insurance card identifies your group and policy number, which is also necessary for billing.

✔ Medicare, Medi-Cal, or Medicaid cards.

✔ Employer information that is necessary for work-related accidents (workers compensation claims).

✔ Responsible party, guarantor and/or insured subscriber information.

✔ Automobile insurance card (in case of an auto vehicle accident).

✔ Primary Care/Referring Physician’s name and phone number.

✔ Pre-authorization forms or referrals.

✔ Consent for minors.

✔ Co-pay/deductible amounts/out-of-pocket maximum. If you are having a scheduled procedure, the Patient Access Team will make every effort to contact you ahead of time regarding your co-pay, deductible and out-of-pocket responsibility.

✔ List of current medications.

✔ Copies of any advance directives and/or Medical Power of Attorney.