Billing and insurance FAQs
Healthcare billing and insurance processing is complicated and can be confusing under even the best of circumstances. Here are some common questions our team hears from patients and families with answers and resources to help you navigate the process. For hospital payments: 952-992-5650.
Why am I being billed?
You are being billed because either we don’t have valid insurance coverage on file or your insurance has processed your claim and there is a remaining balance that is your responsibility. If you need assistance with your statement (bill), please call the phone number on your statement.
Is my insurance being billed?
Children’s Hospitals and Clinics of Minnesota bills your insurance company based in the information you have provided about your coverage.
Why am I getting more than one bill?
You might receive several different bills from one visit to Children’s. The Children’s Hospital bill is primarily for the use of the hospital facility. You may also receive bills from Children’s employed or affiliated physicians, which can include radiologists, pathologists, hospitalists and other employed specialists.. External physician groups may also send separate bills for services rendered in the hospital; examples can include surgeons and anesthesiologists. We all work together to provide excellent health care for your child, but from a billing perspective, we are separate businesses.
What did insurance pay for and what did they deny?
Your insurance should send you an explanation of your healthcare benefits (EOB) indicating total charges, payments and any co-payment or deductible amounts. If you have questions about your EOB and what your insurance company paid or denied, please call the customer service representatives at your insurance company.
What does it mean when my insurance company says they need more information from me or more information from our physician?
Contact your insurance company to find out why they need additional information. It is important to note that they will not pay a claim until they receive the information from you. If they have requested information from you, please contact them immediately.
Can you change a code so insurance will accept the appeal?
Claims for services include diagnosis and procedure coding as required by law. Coding is based on the documentation of services in the medical record. If you believe a code has been applied in error, a request for review can be sent to Children’s Medical Records. Please contact the billing office number located on your statement.
I’m worried about not being able to pay. Can you help?
A health problem in the family can be a stressful experience. Children’s financial counselors can help determine if you qualify for assistance and can help you gain access to government and other programs. To reach a financial counselor at Children’s – Minneapolis, call 612-813-6432. To reach the financial counselor at Children’s – St. Paul, call 651-220-6367.
How do I set up a payment plan?
You can set up a payment plan by calling the customer service phone number on your billing statement. Those phone numbers are:
- For hospital payments: 952-992-5650
- For hospital-based clinic payments: 952-992-5640
- For affiliated clinic payments: 952-992-5560
- For home care/home infusion and retail pharmacy payments: 952-992-5397
How can I find out ahead of time what something will cost?
Children’s Revenue Management Department is able to assist you with understanding the charges and related costs for your procedure. Please contact 952-992-5627 to get a medical cost of care estimate. In order to create an estimate for you, we typically need you to provide us with some basic information such as:
- Brief description of type of service, name of procedure or medical test
- Children’s location where the service will be received
- Your name and return phone number and/or email address
- When you expect to receive care (if known)
- Medical and/or diagnosis codes (if known)
Most cost of care estimates can be created within one business day. It will take longer for complex requests that require more research and/or documentation.
Please be aware that medical cost of care estimates are not legally binding. Costs can and will change due to unforeseen complications and/or changes to the course of care that becomes necessary at the time of service.
We also strongly encourage you to also speak directly with your health insurance carrier on matters of benefit coverage and to better understand your insurance policy provisions such as deductibles, coinsurance and maximum out of pocket amounts.
Help answering your questions
If you have additional questions about your bill, you can contact the respective billing office numbers noted above or the phone number listed on your statement. Customer service staff are available to answer your phone call immediately or get back to you within the day. Emails will receive a response within two working days.
If you have extensive hospitalizations or complicated billing issues, you can request the assignment of a financial case manager to your family. The financial case manager will get to know you and your insurance coverage and will be able to better assist you in resolving your billing issues. You will be able to contact your financial case manager directly by phone or email. Please contact the hospital billing department at 952-992-5650 request a financial case manager.
You can also contact our billing office via email.