Billing Frequently Asked Questions
Q. What is an EOB?
A. It’s an Explanation of Benefits. It shows how your insurance company processed your claim. It contains information such as co-pays, deductibles or non-covered services. EOBs should be kept for future reference.
Q. Which insurance plans are accepted by Abbeville Area Medical Center?
A. Medicare, Medicaid, Blue Cross, Blue Cross State, Humana Tricare (Retirees), Aetna and various other insurances are accepted at AAMC. We will bill any insurance, regardless of participation. However, if your insurance isn’t normally accepted at AAMC, your co-payments and deductibles may be larger than at a participating facility. Note: There may be differences in insurance participation between your doctor and the hospital.
Q. Why didn’t my insurance pay?
A. It could be that your medical situation didn’t meet your insurance company’s definition of “medical necessity.” The reason could also be that the medical care you received wasn’t a benefit of your insurance plan. Often the insurance company will use a “non-emergent condition” as a reason for not paying. Your EOB should provide more specific answers to this question.
Q. Why does it take so long to get a statement showing what I owe?
A. A statement is not generated until all of your insurance companies have responded or made payments. In extreme cases, it may take up to a year for their response.
Q. Why do I get questionnaires from my insurance companies?
A. Insurance companies may need to gather additional information from policy holders before processing payments. Therefore, these questionnaires should be filled out and returned promptly to your insurance company.
Q. If I owe the hospital money, what assistance is available?
A. AAMC offers several payment options based on patient need. Please call our Financial Counselor at (864) 366-5011 for information.
Q. Why doesn’t Medicare pay for some drugs for my outpatient service?
A. This is a congressionally mandated law. (See your Medicare handbook for details.)
Q. When I am getting services at AAMC why am I getting bills from other providers?
A. In order to provide our patients with excellent healthcare, certain services (such as lab work and x-rays, for example) may need interpretations and/or assistance from outside providers.
Q. How do I know if my services require prior authorization?
A. Some procedures will not be paid by your insurance company if you do not receive permission to have them in advance. Please refer to your insurance handbook to learn how your company handles this type of situation, or call the number listed on the back of your insurance card.