Frequently Asked Questions
Find answers to your most frequently asked questions about billing at UC San Diego Helath System. If you prefer to discuss your bill in person, please call 800-755-1533 to schedule an appointment.
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Customer Service
Our toll free customer service department is available Monday through Friday from 8:00 a.m. until 4:30 p.m.
- For bills from the Medical Center or Health System, call 800-755-1533
- For bills from the Medical Group, call 619-543-3000
If you prefer to come in person, please call 800-755-1533 to schedule an appointment.
In April 2003, a federal act called the Health Insurance Portability & Accountability Act (HIPAA) went into effect that protects patient information. The hospital cannot release ANY information concerning your medical record, including financial information, to anyone but you, a legal guardian for patients under 18 years of age, and/or a conservator without written permission unless specifically permitted by law.
The hospital refers some ancillary services to outside medical professionals. For example, we may send laboratory tests to outside physicians for additional medical opinions. In addition, x-rays are read by specialty radiologists. These (and other physicians) may bill you directly.
Please call our customer service department between 8:00 a.m. and 4:30 p.m. Monday through Friday. If you call after hours, please leave a message with your name, date of service and account number. Your call will be returned the next business day.
- For bills from the Medical Center or Health System, call 800-755-1533
- For bills from the Medical Group, call 619-543-3000
Our financial policy is to collect any patient payment responsibility prior to the service being rendered.
Financial Assistance
A financial counselor can assist you with making payment arrangements prior to receiving medical service(s). They will work with you to determine whether or not you are eligible for a Letter of Agreement. If you cannot make payment arrangements or do not contact a financial counselor regarding making arrangements, your medical service may be deferred until acceptable arrangements have been made.
If you do not have health insurance, please contact our financial counselors at 619-543-7188. They can assist you with the application process for public assistance programs, including County Medical Services (CMS) or State programs such as Medi-Cal.
UC San Diego Health System will provide discounted pricing to uninsured patients who do not qualify for charity assistance. The discount is equal to 45% percent of the estimated gross charges for anticipated hospital services. The discount will be automatically applied at the time of billing to all accounts designated as “Self Pay” when charity assistance criteria are not met. Speak with a financial counselor before medical service(s) is/are provided, whenever possible, or before being discharged from the hospital.
Financial counselors are part of the Patient Access / Admissions team. We are dedicated to helping patients and physicians determine sources of reimbursement for hospital services.
As a private, non-profit institution, UC San Diego Health System and Medical Group relies on patient care revenues, commercial insurance, government programs or direct patient payments.
Insurance Billing
You will receive an Explanation of Benefits (EOB) from your health insurance carrier describing the services they have been charged, the amount they were charged, and the amount that was paid by the insurance carrier. The EOB is not a bill.
UC San Diego will make every attempt to ensure that the service(s) we provide has been authorized by your insurance prior to the service(s) being rendered. Not all insurance companies will provide a pre-authorization; therefore, it is UC San Diego Health System's expectation that you are familiar with your insurance benefits. If you are unsure of your medical benefits, call your insurance company to find out if the service(s) you need are a covered benefit. If authorization for service(s) is/are denied by your insurance carrier, we will inform you that authorization for medical service(s) were denied. At that point we can provide a quote and make payment arrangements, if necessary.
It is in your best interest to know and understand your plan benefits, as well as any deductible and co-payment amounts that you are responsible for paying. If you do not understand your coverage, we recommend you contact your insurance carrier. They should be able to explain if the service is covered or not. You can also contact a UC San Diego Health System financial counselor to review your benefits with you.
Yes, you are financially responsible and will be billed for services not covered by your insurance. If you cannot pay the full balance due, you may call customer service to discuss a payment arrangment.
- For bills from the Medical Center or Health System, call 800-755-1533
- For bills from the Medical Group, call 619-543-3000
Patient Billing
Patient financial responsibility is determined by your specific insurance policy. Prior authorization for services may or may not be required. A Patient Access representative or financial counselor is available to assist you with an estimate of what you will owe. UC San Diego Health System's financial policy is to collect co-pays, deductibles and Medi-Cal Share of Cost (SOC) prior to or at the time of service.
Please call our customer service department and we will send you a copy of your itemized bill.
- For bills from the Medical Center or Health System, call 800-755-1533
- For bills from the Medical Group, call 619-543-3000
Physician services that are received as an inpatient (where you are hospitalized) at a UC San Diego Health System facility or as an outpatient at a hospital based clinic are billed separately by the physician. The physician charge is not included in the billing that UC San Diego Health System submits to your insurance, nor are they included on the patient billing statement you receive. All physician services are billed separately from hospital facility services. You may receive separate billing for services from:
- Personal Physician
- Surgeons
- Pathologists
- Emergency Department Physicians
- Specialty Physicians (i.e. Cardiologists, Pulmonologists, ENT Physicians, etc.)
- Anesthesiologists
- Radiologists
Even if you have authorization for a service, you may still have a financial responsibility. The amount you owe is determined by your health insurance coverage. UC San Diego Health System verifies your insurance eligibility and benefits, then determines your financial responsibility, if any. Your policy may require a co-payment, deductible, Share of Cost, and/or out of pocket maximum to be met before coverage is effective.
Patient Financial Services will work with you to resolve any billing discrepancies that may occur. If there is an overpayment to your account, it will be transferred to other open self-pay outstanding balances up to the amount that is due (either for the Medical Center and/or Medical Group). The refund of any remaining overpayment will be sent to the patient/guarantor. If the overpayment is due to a payment from a credit card, the first priority will be to send the overpayment back to the credit card issuer, otherwise, a check will be issued to the patient/guarantor. Please allow 6-8 weeks for the overpayment to be processed.
If you believe you have made a payment in error or have any other issues or questions related to your payment history with UC San Diego Health System, please do not hesitate to contact us.