Common Billing Questions
How can I obtain a copy of my bill?
What are the hours Patient Financial Services is available by telephone?
Patient Financial Services are available by telephone between 8 a.m. and 5 p.m. at 214-456-2455, Monday through Friday.
How is the portion I am going to pay determined?
- The portion you pay is determined by the patient’s insurance plan.
- For outpatient visits, Children's Health℠ will contact you and update your insurance information
- At check-in, Children’s Health will validate your insurance and ask for a co-payment if needed
- Co-payments for clinic visits are generally applied to the physician bill
- Co-payments in Admitting, ER, and Day Surgery are generally applied to Children’s Health
- Patient family signs release of information (at time of arrival)
- Children’s Health bills directly to the patient’s insurance company
- Insurance company processes the claim and sends Children’s Health and the family an Explanation of Benefits (EOB)
- EOB itemizes charges and distribution of payments
- Children’s Health creates a bill showing portions paid and sends it to the family
- You should receive a statement each month listing all your families’ accounts
- The portion you pay is determined by the patient’s insurance plan.
When will I receive my first bill if I do not have insurance?
Families with no insurance coverage should receive the first bill within 10 days of services being provided.
Who is responsible for paying the bill?
Patients without insurance are expected to pay their accounts at the time of service. Patients without insurance are eligible for a self-pay discount. A written policy on Discounting for Self-Pay or Uninsured Patients is available upon request.
Patients with HMO, PPO, and other commercial insurance are responsible for all co-payments, deductibles, and co-insurance at the time of services unless prior arrangements are made with our financial counselor.
Patients with Medicare who do not have supplemental or secondary insurance may also be responsible for co-payments, deductibles, and co-insurance at the time of service.
What is coordination of benefits (COB)?
Some families have two (or more) health insurance plans. The COB tells insurance companies how to split the cost of your health care. It’s important that you fill out a COB form from each insurer – even if you have only one insurance plan. This way, your insurer will know how much to pay for your child’s health care. Contact the member services number or website found on your insurance card(s) for more information.
How long do I have to pay my bill?
Once your insurance company has processed their payment to Children’s Health, the remaining balance is immediately due. You have 90 days from the time it becomes the patient responsibility to pay the bill in full. There is a notification on your bill under each account listed that notes how long the account has been due.
Why does Children’s Health charge as an outpatient facility?
The clinics within Children’s are considered specialty clinics. Generally, insurance carriers consider this as a specialty type visit. Insurance carriers usually have a more expensive co-payment for this type of service. The doctors who treat children in the hospital are highly trained to be the best equipped to handle complex care.
Can CHIP be used as a secondary insurance?
CHIP is a government sponsored program established for uninsured children. There are very few cases that a child can have both commercial insurance and CHIP. Your CHIP case worker may also provide additional information.
Can Children’s Health assist with the physician bill?
Children’s Health is a separate legal entity from the treating physician. If you receive a bill for professional physician services, please contact the phone number on the bill for assistance.
Why is there a limit on how long I have to pay my bill?
Children’s Health has a standard payment policy in place. This policy allows Children’s Health to treat all families equally. This standard is based on several factors including amount owed. Payment plans are a part of the standard policy and plans are set up with regular processes. Please call 800-467-7404 to find out more about payment plans.
Does Children’s Health offer assistance with the bill?
Yes. Many of our patient families are surprised to learn that their child qualifies for assistance. Children’s Health can assist with a financial application and other documents to support financial status. Families with no insurance coverage are eligible for a 25% discount if paid within 15 days from the date of service.
Why do I receive multiple bills for services provided at Children’s Health?
Physicians are not employed by Children’s Health, and bill separately for their services. Due to this you will likely receive multiple statements.
- Children’s Health:
- This statement is for the services provided at Children’s Health. Charges for room, surgical suite, equipment, medications, diagnostic testing, facility feeds, and supplies for treatments for procedures performed appear on this statement.
- The first statement provides the details of services received and the amount billed to your insurance company. Follow-up statements are sent after insurance payments are made and there is a balance due from you.
- Please direct any questions regarding billing, charges, or denied claims to:
- UT Southwestern:
- This statement is for the professional services provided by UT Southwestern physicians, physician assistants, nurse practitioners, etc. Monthly statements from UT Southwestern itemize the services you received, the amount paid by your insurance, and the amount you owe.
- Please direct any questions regarding UT Southwestern’s billing, charges, or denied claims to:
- Third Party Provider Statements:
- You may receive additional statements from laboratories, imaging facilities, physicians and other third-party providers affiliated with, but not employed by, UT Southwestern or Children’s Health. Because these professionals are independent contractors, we do not have access to their billing information. Please contact them directly with any questions about these statements.
- Children’s Health:
Why are the lab charges so high at Children’s Health?
We believe that drawing blood from children is a special skill. Those who do so in the lab at Children’s Health are taught to meet the unique needs of pediatric patients. Children’s Health also has a Pain Free initiative aimed to reduce anxiety and fears related to procedural pain. Not all insurance companies recognize Children’s Health as a preferred provider for lab services. If this is true of your plan, you might be charged an additional out-of-pocket expense for tests conducted at Children’s Health. Please ask your plan administrator if you have any questions.
Can Children’s Health split the bill between two guarantors?
No, Children’s Health bills to one guarantor. The guarantor billed is the guarantor who brought the patient in for services and was approved at that point. They are also the one financially responsible for the bill.
Does Children’s Health provide an estimate of charges before services are rendered?
Figuring out what health care is going to cost can be complex and confusing. There are several factors that affect a patient’s final bill, including treatment decisions, unforeseen complications, additional tests and services ordered by your physician, and the individual needs of the patient. At Children’s Health, we want to help you determine what your out-of-pocket cost may be so that you can make informed choices about your child’s health care.
Price estimator tool
You can now create your own estimate for common procedures and services offered by Children’s Health. Please keep in mind that the amount calculated is an estimate, and that your actual out-of-pocket cost may be more or less depending on the care received and how your insurance company processes your claims. Estimates do not include the fees for those services provided by independent treating physicians, dentists, physician assistants, advanced practice registered nurses, other health care practitioners, transport services and outside testing services. Independent provider fees will be billed separately. It is also important that you contact your insurance company to ensure that the services needed are “covered services” for your plan, and to better understand your coverage within your plan.
If you are a current Children’s Health patient, you can create estimates for a future service or procedure through your MyChart account. Estimates will take into account your insurance information on file. If you are not yet a patient at Children’s Health, you can create a “guest” estimate online.
We are always striving for a better, more patient- and family-focused experience, including support and education regarding your health care costs. Our Financial Counselors are here to help you understand charges, billing and our payment process before, during and after your visit. If you have questions about your bill, estimate, or would like additional information regarding the potential cost of care, we encourage you to contact a Children’s Health Financial Counselor at 214-456-8640 (Dallas) or 469-303-2191 (Plano).
We are always striving for a better, more patient- and family-focused experience, including support and education regarding your health care costs.
Why are there physicians at Children’s Health that are out of network with our insurance, while Children’s Health is in network?
Each physician, or physician group, practicing at Children’s Health is responsible for negotiating contracts with insurance payers. Most independent physicians will provide families with the in-network adjustment on their bill. Please contact that physician billing office for a possible in network adjustment.
Why are Children’s Health charges for services higher than other hospital facilities?
Children’s Health is a tertiary care hospital specializing in pediatrics and our charges may be higher than those in your physician’s office or in a community hospital. However, our charges are similar to those in other pediatric specialty facilities.
I paid a co-payment at the time of service. Is it applied to UT Southwestern or Children’s Health?
- Clinic office visit - your co-pay is generally applied to the physician bill
- Admitting, ER, or Day Surgery – your co-pay will generally be applied to the Children’s Health bill.
Who do I contact with concerns about the quality of medical care during our visit?
Please contact Guest Relations for assistance and follow up on any treatment concerns at 214-456-2273.