We realize that the health care billing process can be confusing. This page will help you better understand the process and what you can do to help at each step. For more information, see
Billing & Insurance or call 855-827-3633.
In addition to the information below, we recommend downloading this guide to understanding health care pricing from Healthcare Financial Managment Association:
Before Your Hospital or Clinic Visit
- As a patient, you should know and understand your insurance plan benefits and your responsibility for any deductibles, coinsurance or copayment 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 billed. To find out what your insurance covers and what your financial obligation may be, call the customer service or member services department of your health insurance company.
- Make sure that your health insurance company lists both your doctor and the hospital as participating providers. For more information, see
Insurance Accepted at UC San Diego Health.
- Obtain a referral, if required. Discuss this with your primary care physician prior to scheduling an appointment with a specialist.
When You Arrive for Your Visit or Hospital Stay
- We will confirm your billing information, including which health insurance plan should be billed. Please provide us with complete information about your primary and/or secondary health insurance and bring your insurance card(s) with you to any visit. Inform us if your personal or insurance information has changed since your last visit.
- When necessary, we will attempt to collect any patient expenses at the point of registration, including deductible or copayment. For certain procedures not covered by insurance you may be required to pay a deposit or pay in full prior to your care. We will make every effort to accurately estimate your portion of the bill. Be prepared to make any required payment prior to service.
After Your Visit: Claim Submittal
- We will bill your primary health insurance company and, if applicable, your secondary insurance company based on the information provided when you registered.
- Your insurance company may ask you to provide more information such as coordination of benefits if you have more than one insurance plan and/or accident details if your service is related to an accident. If so, please respond promptly.
- If you do not receive an explanation of benefits from your insurance company within 30 days, please contact them to find out the status of your claim.
- After your claim is processed by your primary health insurance plan, our billing office will file claims with any of your supplemental insurance plans on file.
- After your insurance company has made payment, you will be expected to pay the amount due. If your insurance company does not pay the entire bill, we will send you a statement to notify you of any unpaid balance. This statement will usually come within 45 days after you have been to the hospital or clinic, unless there is a delay in your insurance company's payment
- If you have questions about your billing statements, or are unable to pay the balance, please call 855-827-3633 or email email@example.com. We can discuss
options for payment plans or financial assistance, depending on your circumstances.
- If your account becomes past due, you may receive up to four balance due notices and four phone calls.
- Keep your billing statements for your records. The billing statements may be helpful when reviewing the explanation of benefits you receive from your insurance company.