Making Sense of Your Hospital Bill

Hospital bills can be confusing. There are three different types of hospital bills that you might receive: a summary bill, an itemized bill and a billing statement.

Summary Bill

summary bill lists out the total charges for your hospital visit and is what the hospital submits to your insurer. Summary bills are often grouped by service categories, such as room and board, pharmacy, laboratory and operating room.

Itemized Bill

An itemized bill includes specific details on the services you were provided, including dates and charges for each item of service. Hospitals are required to provide an itemized bill if you request it.

Billing Statement

billing statement shows the dates of service, the amount billed, the account status, the amount paid by the insurer and the balance due from the patient. Billing statements are issued on a hospital-determined frequency, often monthly.

It is important to remember that in addition to your hospital bill, you may receive separate bills from your physician(s): Emergency Physicians (care provided in an emergency room), Radiologists (imaging services), Consulting Physicians (other physicians brought in by your physician), Pathologists (laboratory and pathology test(s)), Anesthesiologists (surgical procedures) and Surgeons. And, if you are scheduling a hospital visit, be sure to contact your health plan or hospital ahead of time to ensure your chosen hospital, physician(s) and care teams are in your network of covered providers.

If you have health insurance and you visit a hospital emergency department that is not in your plan’s network, you are not required to pay higher copayments or coinsurance. Ask your health plan about your coverage for out-of-network emergency care before you need it, so you’ll be prepared if an emergency arises.

If you have any questions about your hospital bill, contact your hospital’s business office.

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