Answers to Frequently Asked Questions About Insurance, Billing and Payment
Billing statements questions
I received a billing statement. How do I know my insurance company paid its portion?
If you have questions about insurance payments, please call your insurance company directly. The insurance company's phone number is usually printed on the back of your insurance card.
Why are some of my bills from the hospital covered by my insurance, while others are not covered?
Coverage can change every year depending on your benefit plan. This determines whether or not a patient's bill is covered by insurance. Hospital coverage often has a deductible or out-of-pocket expense. Since each plan can be different, we encourage families to carefully review their benefits with their insurance company.
Should I inform my insurance company that my child is going to be in the hospital?
Most insurance companies require you to notify them before you have an inpatient or outpatient visit. Some visits will also require a referral from your primary care physician. We encourage you to check with your insurance company to find out the specific requirements for your insurance plan prior to your visit.
Do I need to have my insurance card or my child's insurance card with me at the hospital or clinic?
Yes, it is very important that you bring your insurance card with you to ensure that we get the insurance billing information to correctly file your claim. You will be asked to present your card each time you register.
How do I know if my insurance is accepted?
We accept most insurance, but these managed care agreements cover Children's Hospital Colorado only. Please check with your physician to ensure that he/she is an in-network provider. You may have to pay additional costs for out-of-network services.
How do I know if my child's visit will be covered by my insurance company?
Health benefit coverage varies with each insurance company or employer group. Please refer to your insurance member handbook or call your insurance company with questions regarding coverage for specific services.
What should I do if I think that my insurance company has paid my bill incorrectly?
If you disagree with the insurance company's payment amount, contact the insurance company directly and ask them to review how the claim was processed. If the insurance company feels the bill was paid correctly and you still disagree, you can contact your benefit manager with your insurance company or find out from the insurance company what you need to do to file an "appeal" with them. Filing an appeal will ensure that your claim will be reviewed for reconsideration.
How do deductibles, co-pays, and co-insurance work?
A co-pay is what you pay when you visit the doctor, to share the costs of your healthcare. Co-pays vary by policy and can change if you see a specialist instead of a regular doctor, or seek treatment out of your provider's network.
Example: Let's say Gary goes to a Children’s specialist with a case of mono. His specialist reviews his insurance and sees that he has a $25 co-pay based on his insurance benefits. His co-pay is collected and his insurance company will reimburse the specialist for the difference between the co-pay and the cost of treatment.
- Health insurance co-insurance
Co-insurance is the way you and your health insurer share the costs of your care. For example, if Gary is injured, and he's met his deductible for the year, his health plan will pay 80% of the cost of the rest of his bills, leaving him responsible for the remaining 20%.
- Health insurance deductibles
Your deductible is the amount of your medical costs that you have to pay before your health insurance takes over.
Example: Gary has a health plan with a $1,500 deductible. If Gary only has a few little things go wrong during the year that cost less than $1,500 total, he's going to pay the full amount to treat them. However, if Gary has a serious illness that requires a lot of medical care to get better, he'll pay his $1,500 deductible and then his health insurance takes over to pay most, if not all, of his additional costs.
Summary of health insurance deductibles, co-pays, and co-insurance
- You pay co-pays when you see the doctor
- Co-insurance is how you and your insurance company split up your care
- Deductibles are the portion you must pay before your insurance pays its share
Can I pay my bill online?
Yes, you can pay your hospital bills online. Or contact UPI billing to pay your UPI bill: (303) 493-7700.
If I pay online, can I get a receipt?
Yes. Once you have paid, a confirmation screen will appear. Select the option to print the receipt.
When do I pay my co-pay, co-insurance, or deductible?
Your co-pay, co-insurance, or deductible is due when you register. If you are unsure of your financial responsibilities, please look at your insurance card, or call your insurance company.
How can I pay my balance?
We offer several payment options:
- You can make a one-time payment or set up an automatic monthly payment arrangement for Children's Hospital Colorado online. Go to “Pay Your Bill."All major credit cards are accepted.
- You can pay by mail. Make the check or money order payable to Children's Hospital Colorado Association and include your patient account number. Mail to:
Children's Hospital Colorado Association
Denver, CO 80291-1611
3. Call our Customer Service Team at (720) 777-6422.
What if I can’t pay my bill in full?
You can set up automatic monthly payment agreements by contacting our Customer Service Department at (720) 777-6422.
My child's medical bills are adding up fast, and I can't afford to pay them. How can I get help?
We are committed to providing health care to children, regardless of family income. Many of our patient families are surprised to learn that their child qualifies for assistance. Please call one of our financial counselors at (720) 777-6422 and select to be transferred to one of our financial counselors to discuss financial assistance options. Our financial counselors can help you apply for a variety of financial assistance programs.
I made a payment, but I received another billing statement. Why?
The statement could have been generated prior to your payment, but if you have made a payment and received a bill, please call our Customer Service Team at (720) 777-6422 and we will be happy to review your payment(s) and any remaining balance(s).
I received a letter stating my account has been referred to a collection agency or collection attorney. Why was this done and what should I do?
Before an account is placed with a collection agency, you will receive three billing statements from Children's Hospital Colorado advising you of your child's account activity. You may also receive phone calls from Children's billing office personnel during this billing period.
After these steps have been taken and payment or payment arrangements have not been made, the account is then referred a collection agency. Once an account is placed with an outside collection agency, we ask that parents work directly with the agency to resolve the balance. We hope this lessens confusion and frustration by eliminating unnecessary phone calls for families.
Billing statement answers
Will you bill the insurance company for my child's visit?
We will file your claim with the insurance company that you provided to us. It is very important that you provide us with all of the necessary information at the time of registration to file your claim with your insurance company. It is ultimately your responsibility to ensure that your insurance company has all of the information that they need from you in order to process your claim.
Will you bill both my primary and secondary insurances?
We will bill all of the insurances that you provide to us for each visit. The insurance(s) that we have on file for each visit will be listed on your statement.
How does my insurance company receive the claim for health care services?
Children's Hospital Colorado sends the claim to your insurance company. To ensure prompt, proper claim processing, please verify we have the proper insurance information on file when you register.
What is the difference between hospital and physician billing statements?
You may receive separate bills for services for physician services and Children's Hospital Colorado. For more information, please read detailed descriptions of each type of statement in the billing guide for families.
Why do I receive two billing statements when my child only sees a physician at Children's Colorado?
With most physician-related services performed at our hospital, there is a corresponding hospital facility fee. This is because the services are performed at the hospital (or a hospital outpatient center) and not in an independent physician's office.
Why do I receive billing statements from the hospital when my child was never there?
Children's Hospital Colorado provides a wide array of medical-related services for independent clinics and physicians, as well as other hospitals. For example, a pediatrician or a free-standing health center may refer lab work to Children's for testing or analysis. When this occurs, the bill for the lab services will come from Children's Hospital Colorado and not the pediatrician or health center.
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