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t guide.indd 1A Patient’sGuide to Billing:Understanding Hospitaland Physician Bills9/5/14 11:36 A

t guide.indd 29/5/14 11:36 A

t guide.indd 1Table of ContentsIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Two Separate Billing Departments . . . . . . . . . . . . . . . . . 3Hospital Billing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Physician Billing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Insurance Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Patient Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7How Your Payment Is Posted . . . . . . . . . . . . . . . . . . . . . . 8How to Make Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Contact Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109/5/14 11:36 A

t guide.indd 2IntroductionMemorial Sloan Kettering Cancer Center’sphysicians, nurses, social workers, and otherhealthcare professionals are dedicated to providingpatients and their families with the most advancedand highest quality care available. Likewise, PatientAccounts, the Physician Billing Department andPatient Billing Services are committed to providingcaring and responsive service to our patients.This guide is intended to help you better understandyour hospital and physician bills and your financialresponsibility for the care you receive at MemorialSloan Kettering Cancer Center (MSK). Please keepit as a reference during the course of your treatment.If you need additional assistance, please do nothesitate to contact us. Our contact information islisted on the back page of this guide.In addition to this guide, you can find valuablebilling information on your MyMSK account.MyMSK allows you to view your hospital andphysician bills online, update contact and insuranceinformation, make payments online, and sendsecure messages to the Patient Billing Services. Toaccess MyMSK, you must be enrolled. Please ask asession assistant in clinic or contact your physician’soffice to enroll or learn more about MyMSK. Youcan also contact the MyMSK Help Desk by calling800-248-0593 or 646-227-2593.29/5/14 11:36 A

t guide.indd 3Two Separate BillingDepartmentsWhen you visit one of MSK’s treatment sites,the care you receive may consist of a visit toyour physician, a diagnostic test, an outpatientprocedure, or other forms of treatment. Eventhough you may receive only one type of treatmentthat day, for many services you will receivetwo bills — one from the hospital and one fromthe physician. For example, if you have a x-raytaken, you will receive a bill for the facility costsinvolved in performing the x-ray and a bill forthe radiologist’s interpretation of the film. Thisis because we bill separately for hospital andphysician charges.Hospital charges are for the use of hospitalfacilities and the outpatient clinic servicesprovided by the nurses and other members of yourcare team who are not physicians; in addition toany tests (labs, radiology) you may have while atMSK. These charges will appear on a bill sent toyou by our Patient Accounts Department.Physician charges are for the doctor’s time,expertise, and your examination and/orconsultation. These charges will appear on a billsent to you by our Physician Billing Department.39/5/14 11:36 A

t guide.indd 4Hospital BillsPage 1 of 6December 31, 2012Hospital Outpatient StatementPatty Patient1275 York AvenueNew York, NY 10065Account # 301111114Medical Record # 00111111This is your current insurance information on file.Patty Patient96 Second Avenue, Apt. JNew York, NY 10005Insurance Company NamePolicy NumberOXFORD HLTH PLAN5000000001Use the back of this page to update demographic and insurance information.New charges since your last statement which are being billed to your primary insuranceDate 2/07/12Charge DescriptionInsuranceBilling CodesOutpt Visit-Est Pt-Lvl 1Comprehensive Metabolic PanCa Antigen (Ca-125)Thyroid Stimulating HormoneCarcinoembryonic Anigen (CCbc W/ Automated DifferentiCharges992118005386304844438237885025 181.00 398.00 215.00 214.00 215.00 48.00 1,271.00New Charge Total 629.27- 50.00 150.00What You Owed on Your Last StatementPatient Payments Received Since Your Last StatementPatient Responsibility Since Your Last Statement 729.27What You Owe NowMemorial Hospital Taxpayer ID#:13164082National Provider ID# 1700887411Diagnosis Code: V10.05Note: Please save thispage. These chargedetails will not appear onnext month’s hospitalstatementTo assist in understandingthis Statement, pleaserefer to the Explanationof Balance page.A list of frequently askedquestions and contactinformation is on the lastpage of this statement.Pay on-line by credit card or electronic check by using MYMSK or https://pay.usbank.com/MSKCC.If not paying through MYMSK or https://pay.usbank.com/MSKCC, return this section withyour payment. Please make checks payable to Memorial Hospital and write your account number on the checkWhat You Owe Now: 729.27Medical Record # 00111111Account # 301111114Statement Date: 12/31/12Patient Name:Patty PatientAmount Authorized or Enclosed: Patty Patient96 Second Avenue, Apt. JNew York, NY 10005Card NumberMastercardExpiration DateDiscoverCardholder NameAm ExpressCardholder SignatureDiners ClubMail Payment to:Memorial HospitalGeneral Post OfficeP.O. Box 26174New York, NY 10087-6147VisaHKB41There are two different types of hospital bills —one for outpatient care and one for inpatient care.Hospital outpatient bills are sent monthly andinclude charges for services you’ve received at allMSK treatment sites along with insurance andpatient payments and adjustments. You will onlyreceive statements when you have an outstandingbalance. Hospital inpatient bills are sent after eachadmission approximately ten days after discharge.Hospital bills are also available online if you areenrolled in MyMSK (see page 2 for information onhow to enroll).49/5/14 11:36 A

t guide.indd 5Physician BillsG4Physician Billing DepartmentMRN:00111111PATIENT: PATTY PATIENTCHARGE CHARGE 05/09/1304/20/13279.50PAY YOUR BILL ONLINE - REGISTER AT https://epay.mskcc.orgPATTY PATIENT96 SECOND AVENUE, APT. JNEW YORK, NY 100055543 1 MB 0.402 DAY1G4(STATEMENT DATE: APRIL 20, 2013)00111111PATTY PATIENT1111000006/15/1207/20/1208/09/12 PAYMENT PRIMARY INSURANCE.KLAUS BUSAM MDPATHOLOGY PRIVATE GROUP06/15/12 CONSULT.PAY YOUR BILL ONLINE-REGISTER AT epay.mskcc.org 325.00 325.00 325.00-45.50 279.50ACCOUNT BALANCEAMOUNT PENDINGWITH INSURANCEKINDLY REMIT INFULL BY 05/09/13 279.50 0.00 279.50005543 001 001There is only one type of physician bill which is forboth outpatient and inpatient care. Physician bills aresent monthly to patients and list all physician charges,along with insurance and patient payments andadjustments. If you have received services at morethan one MSK treatment site, you may receive morethan one physician bill.Physician bills are also available online. You can sign upto receive them electronically at the following website:https://epay.mskcc.org. You will need to have your8-digit medical record number in order to register.Please note that physicians and their staff are not ableto assist with billing matters.If you would like more information and/or assistanceabout the hospital or physician bills, please contactPatient Billing Services. See Page 10 for contact details.59/5/14 11:36 A

t guide.indd 6Insurance CoverageHealth insurance is a major concern for cancerpatients and their families. Each health insurancepolicy is different, we encourage you to take the timeto understand your health insurance policy.MSK will handle insurance required pre-certificationon your behalf, regardless of your insurancecarrier for the following services: inpatient stays,emergency admissions, outpatient surgeries, andradiation therapy. MSK also pre-certifies radiologyprocedures such as CT scans, MRIs, and PET scansfor all insurance carriers. The authorization numberobtained from the insurance company is postedon MyMSK 24–48 hours before admission or theoutpatient service or procedure.If you are not clear about the details of yourinsurance coverage, contact the Customer Serviceor Member Services Department at your insurancecompany (the phone number is listed either on yourinsurance card or in your benefits book). They shouldbe able to tell you more about your in-network andout-of-network coverage for care at MSK.69/5/14 11:36 A

t guide.indd 7Patient ResponsibilityPatients are responsible for any balance not paid bytheir insurance carrier. These charges, also calledout-of-pocket expenses, may include co-pays,coinsurance, deductibles, and charges that arenot covered or that have been denied by yourinsurance carrier. Patients are also expected to payfor prescription co-pays. MSK accepts all majorprescription cards for take-home medications.For patients with out-of-network benefits, eachinsurance carrier has an established payment ratefor each test, procedure, or other medical service.This rate is called reasonable and customary.MSK’s charges may be different from an insurer’srates due to the complexity of treatment providedto our patients. Patients are responsible for payingany difference between MSK’s charges and thecarrier’s rates.If you do not have health insurance or are worriedthat your health insurance may not cover yourMSK bills in full, we may be able to help. Pleasecontact Patient Billing Services; we will work withyou to find alternative payment options. In addition,for those who qualify, MSK does offer financialhelp to patients in need through our FinancialAssistance Program.79/5/14 11:36 A

t guide.indd 8How Your PaymentIs AppliedIn general, we apply patient payments to theoldest charges first. However, we can apply yourpayments to specific service dates or, in the case ofphysician bills, to specific physicians. If you wouldlike us to apply your payment to a specific servicedate or physician, please include instructions alongwith the payment. Please do not write instructionson your check.If you receive a payment directly from yourinsurance carrier, please submit the payment alongwith a copy of the insurance carrier’s Explanationof Benefits, which you should have received withthe payment.89/5/14 11:36 A

t guide.indd 9How To Make PaymentsHospital Inpatientand Outpatient BillsBy MailPatient AccountsDepartmentGeneral Post OfficeP.O. Box 26174New York, NY 10087-6174Physician BillsPhysician BillingDepartmentGeneral Post OfficeP.O. Box 26352New York, NY 10087-6352By PhonePatient Billing Services866-248-1274 or 646-227- 33788:00 am to 4:30 pm Monday – FridayOnlineYou can make paymentby credit card orelectronic check drawnon a US-based bankthrough MyMSK.*You can also pay directlyusing https://pay.usbank.com/MSKCC.To make a payment,sign up at https://epay.mskcc.org. You willneed your medical recordnumber to register.You can also use MyMSKto make a payment.** To enroll in or learn more about MyMSK, pleaseask a session assistant in clinic or contact yourphysician’s office. You can also contact theMyMSK Help Desk by calling 800-248-0593 or646-227-2593. (For privacy reasons, MyMSK is onlyavailable for patients 18 years and older.)For Hospital Inpatient/Outpatient Bills: Please besure to provide your account number with payment.The number can be found on your hospital bill.For Physician Bills: Please be sure to provide yourmedical record number with payment. The numbercan be found on your physician bill.99/5/14 11:36 A