Understanding Your Bill

Understanding Your Bill

Bill Title lets you know whether the bill is a normal billing statement or a payment plan notice.

Bill Summary provides an overview of the statement’ s contents, including patient information and charges.

For an itemized list of charges, flip the bill over.

Perforated Check Stub makes mailing in check payments simple! Include this stub in the envelope with your check.

RENOWN HEALTH | PO BOX 4072 | Alameda CA 94501-4072

PO BOX 4072, Alameda, CA 94501-4072 RETURN SERVICE REQUESTED

Billing Statement

John Smith 123 Main Street, Apt 3 Nowhere, GA 12345-6789

Bill Summary See following page( s) for itemized charges

Guarantor Name: Guarantor Number:

Amount Due: $ 994.00

Name:

Paying With Check? Detach and return lower portion with payment

DUE BY 06 / 10 / 2020

$ 994.00

Thank you for choosing Renown Health for your healthcare needs.

Guarantor Number: Secure Health Code:

John Smith abc123

PCO-PCO-PCO

Amount Due: $ 994.00

Payment Included $

John Smith abc123 Statement Date: 05 / 13 / 2020

Total Charges: $ 5,054.30 Adjustments / Discounts:- $ 2,000.24 Insurance Payments:- $ 2,060.06 Patient Payments: $ 0.00

Important Message

The Guarantor is the person who ultimately accepts financial responsibility to pay the patient ' s bill. In most cases it is the adult patient receiving the service. If the patient is a child, the responsible party may be the child ' s parent or legal guardian.

Ways To Pay

Pay Online Visit: mychart. renown. org

Pay on Smartphone Scan QR Code

Pay by Phone

Call: 833-374-0081 Enter Pay by Phone Code: 123-456-789

Pay by Mail

Complete the form below and return in the enclosed envelope. Make check payable to Renown Health

Payment Options

Learn more about the following options on the back of this page, or visit mychart. renown. org Tenemos representates disponibles que hablan espanol Telefono 775-982-4130 O llamada sin cargo 866-691-0284.

Payment Plans Financial Assistance

Have Questions?

Call: 775-982-4130 or 866-691-0284. Hours:

Mon-Fri 8:00am- 6:00pm

If paying by check, make payments to:

RENOWN HEALTH PO BOX 4072 Alameda, CA 94501-4072

Flip Page

Amount Due shows your total patient responsibility and when it is due.

Ways to Pay lists payment options. You can pay online at mychart. renown. org or by scanning the QR code provided, pay over the phone 24 hours a day by calling 833-374-0081 and following the prompts, or pay via mail by following the instructions provided.

Questions regarding your bill can be answered by sending us a secure message in your MyChart or by calling 775-982-4130.

0715218933940084 0000024000

PCO-PCO-PCO 1 05 / 13 / 2020 COLOR-DUP IMBT _ BOTH 994.00 1 / 2