Insurance and Hospital Fees
John T. Mather Memorial Hospital participates in various insurance plans, including Aetna, Blue Cross, Cigna Healthcare, GHI, HIP, Island Group, Oxford, PHCS, United Healthcare, Vytra, Medicare and Medicaid programs. Some insurance companies will specify specific providers for certain outpatient diagnostic services such as laboratory or diagnostic radiology. Other insurance plans require a referral from your primary care doctor, while other plans may require prior authorization for certain services.
There are many different contracts within each insurance company. It is always wise to check your individual coverage within your contract to avoid unforeseen expenses to yourself. You may bring your insurance policy or booklet with you before your scheduled treatment or admission and have one of our patient account representatives in the business office review the information with you. If you have questions about your coverage, we invite you to call our patient accounts department at (631) 476-2801.
Many diagnostic procedures performed at the hospital consist of two parts – the technical (hospital) part and the professional (physician interpretation) part. There will be a separate bill for each of these procedures. For example, there will be a hospital bill for each use of imaging equipment, imaging technicians, and a radiologist (physician) bill for the professional interpretation of the imaging. Professional services provided by radiologists, cardiologists (EKG reading), anesthesiologists and pathologists are not included in the hospital bill. These specialists may not necessarily participate in the same insurance plans as the hospital.
If you have any questions regarding your insurance coverage, please contact our patient accounts department at (631) 476-2801.