Understanding Your Medical Bill
We're here to help. Learn how our billing process works, your rights as a patient and what programs are available to those in need to help with the cost of care.
Sorting Out Your Paperwork
You may receive several documents in the mail following an appointment. Learn what each one is and easily identify your bill.
As a patient, you can request estimates for your care based on the anticipated services, your insurance coverage and other factors. Before you receive certain tests, procedures or health care services at our facilities, we may also send you an estimate of the anticipated costs.
In some care settings, you can get a 10% discount if you pay your estimated costs before your scheduled appointment.
Your insurance provider should send you an Explanation of Benefits (EOB) every time they process a medical claim for your care. It lists the claims, how much health insurance paid and any balances you may be responsible for based on your coverage plan and other factors like your deductible, out-of-pocket costs and in- and out-of-network services.
After insurance pays its share of your health care costs, we’ll send a bill describing the care you received and your remaining out-of-pocket costs owed. Because facilities, physicians and caregivers and medical equipment can be billed separately, you may receive more than one bill per visit.
The Providence Billing Process
Learn how your medical bill is processed at Providence.
First: You Get Care at Providence
When you visit a Providence facility, we note your health care insurance information and the services you receive.
If you don't have insurance, you will receive a detailed statement in the mail 7-10 days after you are discharged, which will include information about financial assistance or payment options.
Second: We Submit an Insurance Claim
When you visit a Providence facility, we note your health care insurance information and the services you receive.
If you do not have insurance, you will receive a detailed statement in the mail 7-10 days after you are discharged, which will include information about financial assistance or payment options.
Third: You Get a Bill for Out-of-Pocket Costs
After insurance pays its share of your claim, we will bill you for the remaining out-of-pocket costs.
You can choose to…
If Your Bill is Unpaid After…
- 31 Days: You will receive a past-due notice
- 61 Days: You will receive another notice
- 75 Days: You will receive a final notice
- 121-181 Days: You may be sent to collections
You can apply for financial assistance at any point during your care journey and the billing process. If you apply after receiving a bill, your bill will be placed on hold while your application is being reviewed. Your bill will not be sent to collections while you’re applying for financial assistance.
Decoding Your Bill
Here's what different kinds of medical codes mean and how they're used for billing.
ICD-10 codes describe your condition or injury, as well as other aspects of your health. They’re used to determine what services or procedures you may need.
Examples:
- S62.5 – fracture of thumb
- E119 - Type 2 diabetes mellitus without complications
- J45.30 - Mild persistent asthma, uncomplicated
These standardized procedure codes specify the care you received. Each has a clear, published cost from your provider and a specific reimbursable amount from your insurance provider.
Examples:
- CPT® 45378 - Diagnostic Colonoscopy
- CPT® 80061 - Lipid panel
- M1069 - Patient screened for future fall risk
- G0379 - Direct admission of patient for hospital observation care
Professional and facility codes detail services from specific facilities, such as nursing time, medicine given or supplies used.
Your Billing & Price Transparency Rights
In each state, laws exist to help protect you from unfair medical billing.
The federal No Surprises Act also helps to prevent unexpected bills, facilitates cost estimates and limits charges from out-of-network providers.
More Billing Policies
We may send bills that aren’t resolved in 121-181 days to an outside collections agency. But if patients are working with their insurance provider or applying for financial assistance, collections are paused.
If you want to discuss an error in your bill, call the patient billing office. Contact us to find local contact information for your area. You can also notify us in writing about inaccuracies. Written disputes should be mailed directly to your hospital at the address on the front of your bill.
Recently, a government program that helped cover COVID-19 testing, vaccination and care ended. Now patients may be billed for some COVID-19 services. If you need help with the costs of this care, please visit the Financial Assistance page and learn more about how we can help.
Contact Resources
To easily access the billing support you need, visit our contact resources directory. You'll find detailed contact information, hours of operation and the option to receive prompt assistance either by phone or email.
Top Billing FAQs
We’re here to help. If you are unable to pay for some or all of your medical care, you may be eligible for Providence’s financial assistance program. This program provides free or discounted services to eligible patients.
Our financial counselors can also assist you in applying for many government programs that can help with the costs of care. And we offer interest-free, long-term payment plans starting at $25 a month and lasting up to 24 months.
Please note that if you have not yet received a bill, you will not be able to set up a payment plan. If you’ve received a bill and would like to set up a payment plan, visit our Online Bill Payment page and choose your state to get started. However, financial assistance applications can be filled out at any time before, during or after you receive care.
If you wish to discuss concerns about your bill, call the patient billing office at 800-378-4189, Monday through Friday, 8 a.m. - 4:30 p.m. or any of the phone numbers listed on the front of your bill.
Or you can notify us in writing if you think your bill is inaccurate. Written disputes should be mailed directly to your hospital at the address listed on the front of your bill. Please include:
- Your name and account number
- The charge you feel may be inaccurate
- An explanation of why you believe the bill is in error
After we receive your written concerns, we will:
- Acknowledge receipt of your letter within 30 days
- Pause all formal collection attempts until we have responded to your concern
- Respond to you or explain the delay within 60 days of receipt of your letter
- Correct your bill, if an error is verified
Because facilities, physicians and caregivers and medical equipment can be billed separately, you may receive more than one bill per visit. For example, you may be billed separately by each physician (e.g., surgeon, anesthesiologist, radiologist, pathologist, intensivist or hospitalist) involved in providing or reviewing your care.
Providence determines your bill based on several factors, including the costs associated with the following:
- Specific medical services, treatments and procedures you receive
- Duration of your hospital stay
- Complexity of your condition
- Medications administered
Additionally, the bill may also take into account your insurance coverage, applicable discounts, financial assistance and any outstanding balances from previous visits. Your financial responsibility will be determined based on your insurance plan's coverage.
The billing process is transparent, and you can inquire about the details of your bill by contacting Providence's billing department or reviewing the itemized statement provided to you.
We offer a 10% pre-pay discount if you pay an estimate on or before your day of care. Self-pay discounts for people not billing insurance are also available.
We understand that medical expenses can be challenging to manage. Providence offers a financial assistance program to eligible individuals, providing discounts based on their income and financial situation.
When you visit a Providence facility, we note your health care insurance information and the services you receive. If you’re insured, we submit a claim to your insurance provider with all the details they need to process your claim. Insurance then pays its share based on the terms of your coverage.
After insurance pays its share of your claim, we will bill you for the remaining out-of-pocket costs.
Once you receive your bill, you have 31 days to pay, set up a payment plan or apply for Providence’s Financial Assistance program before you receive a past-due notice.
- At 61 days, you will receive a past-due notice to pay your bill, set up a payment plan or apply for Providence’s Financial Assistance program.
- At 75 days you will receive your final notice before your bill is considered for pre-collection status.
- Next, depending on your situation, your bill may be sent to a collection agency after 121 to 181 days.
- If you have any billing questions or are interested in enrolling in a payment plan, contact the billing customer support team. Our interest-free, long-term payment plans start at $25 and can last up to 24 months.
If you need help paying your bill, explore the resources we have available to help cover the costs of care.