Billing Frequently Asked Questions( FAQ)
ALB / 1904-SP006400 outside of the HMO’ s network for non-emergency care, coverage for that care is impacted and may not apply.
ICD-10
• ICD-10 stands for International Classification of Diseases, 10 th Revision. ICD codes classify diagnoses and health issues of patients using four to seven digit alphanumeric codes, which denote signs, symptoms, diseases, conditions, and injuries. Both CPT and ICD-10 codes must be provided to insurance companies for the provider to be reimbursed properly.
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.
Managed care
• A type of insurance plan that required patients to see only providers that have a contract with the managed care company, barring exceptions such as emergency or urgent care when the patient is outside of the plan’ s service area.
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. Depending on your insurance, you may have higher out of pocket costs when receiving care from an out of network doctor or hospital.
Out of Pocket Maximum
• The maximum amount a person needs to pay themselves.
Patient Responsibility
• The amount the patient is expected to pay.
Pay by Phone Code:
• This code enables you to use the automated phone payment system.
Our Mission Renown Health makes a genuine difference in the health and well-being of the people and communities we serve.