UTMB > Financial Information

Financial Information, Billing Practices and Charity Care

New: Scheduling, Registration
and Billing System
 
Single Statement

Billing and Inquiries 

Insurance Network Participation 

Online Bill Payment 

Interest Applied and Billing FAQS 

Estimates 

Charity Care and Financial Assistance Policy 

Itemized Statements 

Care Management 

Insurance Claims and Payment Policies 

Patient Complaints and Policies 

Here to HelpAt UTMB Health, we're committed to providing the very best medical care to all our patients. We're equally committed to making it simple to access our services, to clearly state our financial and billing practices, and to give you a sense of what to expect during and after your appointment, procedure or hospital stay. We also want to answer questions you may have in a timely fashion. This page outlines our practices and answers a number of common financial questions:

Billing

In an effort to enhance your health care experience, effective April 6, 2013, UTMB Health began providing a single statement for all of your health care encounters. The new statement combines all fees related to clinic visits, hospital stays and other related charges. [read more on the single statement]

For services provided before April 6, you will receive statements from both Hospital Patient Financial Services and the Faculty Group Practice Physicians’ Billing Service. Hospital Patient Financial Services bills for hospital charges, such as your room, laboratory tests, X-rays and medications. Professional fees charged by your physician, anesthesiologist, radiologist or other medical consultants who cared for you are billed separately by the Faculty Group Practice Physicians’ Billing Service.

Billing Inquiries

UTMB Health is also pleased to offer a single point of customer service to our patients, so that we may answer all of your billing questions with one phone number, instead of requiring separate phone calls to different billing offices for hospital/clinic fees and health care provider charges.

Call for assistance

 

You may contact our Customer Service Office
at (800) 435-1871 or (409) 747-1099.

 

 

Online Bill Payment

UTMB Health offers a secure and convenient online bill payment option for its patients. All major credit cards and eChecks are accepted. [Access Online Bill Payment]

Requesting an Estimate

UTMB Health can provide an estimated cost of medical services to patients upon their request. Estimates are prepared by the Admitting Services Department and can be requested by calling (409) 747-4785.

To expedite the estimate process, please be prepared to provide your insurance plan name and policy information, information about yourself, and about the specific service(s) being requested.

While we work to expedite estimates, an estimate request may delay scheduling and provision of inpatient admission, procedure or other requested service(s). Customized estimates are based on an average charge comparison for past services provided for the same type of procedure/service; they do not include charges that may be due to complications, extenuating/co-existing clinical conditions, or additional procedures that may be necessary. Actual charges may differ from the estimated amount, and from the amount to be paid. [Read the complete Estimate Request Policy

Requesting an Itemized Statement

UTMB will mail you a monthly statement on each account on which you owe a balance. If you would like to receive a more detailed list of your hospital or professional charges, you may request an itemized statement. Our customer service account specialists can assist you via telephone, or you may submit a request for an itemized statement via email. Statements will be sent via US Mail to you at your address of record.

For itemized bills and information, please call (409) 747-1099 or (800) 435-1871 or email HPFS.epay@utmb.edu 


[Itemized Statement Policy] [Request an Itemized Statement]

Insurance Claims and Payment Policies

All accounts are payable in full upon receipt of your statement. If you have commercial health insurance, your coverage will be verified and a claim will be filed on your behalf. Our billing departments will cooperate fully with you and your insurance company to expedite payment of your claim.  If you have assigned insurance benefits to UTMB, your insurance company has 60 days from the date the claim is filed to complete payment.

In the event your insurance company fails to pay the claim after 60 days, it may be necessary for UTMB  to ask you to pay your hospital or physicians’ bills.

Please remember that the patient or guarantor, not the insurance company, is responsible for the settlement of the account. Once your insurance payment has been received, any remaining balance is expected in full, within 30 days.

If you cannot pay your patient balance in full, it may be possible to establish a payment plan. The term and payment amount is determined according to the amount owed. A customer service account specialist can assist you in establishing a payment plan. For more information, please call: 

For payment plan information, please contact our Customer Service Office
at (800) 435-1871 or (409) 747-1099.

Insurance Network Participation Notification

It is policy at UTMB Health for our registration staff to provide a written disclosure to all patients receiving care as to whether the services requested/received are considered in-network or out-of-network. The guidance UTMB provides is based on the information provided by the patient at the time of service, and availability of the insurance company or other provider to confirm coverage details. Disclosures are provided in the Emergency Room, inpatient areas, day surgery units, ancillary areas, and clinics.
[See Network Participation Policy]  

Interest Applied to Billed Services

At this time, per its current policy, UTMB Health does not apply interest charges to bills issued for its clinical services. [See policy]

Billing FAQs

We've posted a short list of answers to other frequently asked questions to help you understand your billing statement and our financial practices. [Access FAQs]


Charity Care and Financial Assistance Policy

Current UTMB patients are eligible to apply for financial assistance related to services already provided at UTMB. Existing UTMB and non-UTMB patients may contact Financial Counseling at (409) 772-6464 to learn about referral requirements and the application process related to planned services.

Patients are not eligible for financial assistance if they a) have third party insurance; or b) if they are eligible for another third party program such as Medicaid, County Indigent Health Programs (CIHCP), etc; or c) are not Texas residents. Patients seeking treatment for certain elective, non-emergent procedures will be considered full pay patients, and payment in full will be expected at or before the time services are rendered.

Qualified applicants whose income and calculated assets are below 200% of the levels indicated in the Federal Poverty Guidelines (found at http://aspe.hhs.gov/poverty/) will qualify for a 100% charity discount on any balances (established deposits for planned services are still required). Qualified applicants whose income and calculated assets are equal to or greater than 200%−but below 400% of the Federal Poverty Guidelines − will qualify for a 50% charity discount on any balances (established deposits for planned services are still required).

The Financial Counseling Office manages the process of vetting requests for assistance. An interview/screening process conducted by the office will determine if an individual is eligible to receive discounted medical services at UTMB.

Self-pay patients (individuals who are personally responsible for their bills because they do not have third party coverage, and do not qualify for full or partial charity care discounts) with income levels equal to or greater than 400% of Federal Poverty Guidelines may qualify for discounts up to 40% for inpatient services and 50% for outpatient services received.


Care Management

UTMB is an academic teaching facility, and as such, you may see a variety of care providers during your stay with us. Care managers are assigned to medical teams to address needs during your hospital stay. These needs may include ensuring that high-quality care is delivered in an efficient manner, proactively planning for your discharge early during your hospital stay, and identifying solutions to discharge barriers that could otherwise delay your return home.

Care managers are available Monday–Friday, 8 a.m.–5 p.m. If you anticipate problems returning home after discharge, please contact (409) 772-1541 so your care manager can speak with you about your concerns.

Patient Complaints

At UTMB Health, our goal is to care for you in a manner that consistently meets and exceeds your expectations. If we fall short of that goal, our Patient Services department is in place to provide a centralized and effective mechanism to investigate, address and hopefully resolve a given issue.

You may contact the department by mail, phone or email:

UTMB Health Department of Patient Services
Route 0306
Galveston, Texas 77555-0306
(409) 772-4772
patient.services@utmb.edu

[Visit the Patient Services Web Page] [See the Patient Complaint Policy]


Policies regarding UTMB Health’s Discounting, Pricing and Billing Procedures

In accordance with Senate Bill 1731 (“Healthcare Transparency”) and in addition to the information offered above, UTMB posts for its patients policies on billing and collection practices. If you don’t have access to the Internet or would prefer a written copy, please call (409) 747-4004 or 1 (800) 228-1874.

Available documentation on policies and procedures include:

  • Discounting charges for uninsured patients [See policy]
  • Requesting an estimate of services to be provided [See policy]
  • Requesting itemized statements of services provided [See policy]
  • Interest applied for billed services [See policy]
  • Addressing complaints [See policy]
  • Informing patients about UTMB’s approved provider status on individual insurance plans [See policy]

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