UTMB Patient Financial Responsibility Policy
It is important for patients to understand the costs of their health care before deciding on services. Calculating all costs beforehand can be a confusing process. UTMB’s Patient Financial Policy helps explain this process. The following information is provided by UTMB to help answer questions you may have related to your visit.
Determining Your Estimated Costs
We try to review your estimated financial responsibility with you prior to your scheduled service. You may receive a call to explain the estimated amount you may owe for your upcoming service, plus any unpaid bills you might have for previous services.
Final charges may be different from the costs discussed in the phone call if the actual treatment is modified at the time of service.
Financial Responsibility of the Patient
For any scheduled service, UTMB Health requires a deposit be made prior to service for any amount not covered by insurance, including deductibles, co-payments, and co-insurance. If you do not provide us with insurance information or you do not have active insurance coverage, payment for all services is your responsibility.
If you are unable to make a deposit prior to service or you if arrive for your service and cannot make the required payment, your visit may be rescheduled for a time when you will be able to make the payment.
Services Not Covered by Insurance
Some services are not covered by insurance companies. (For example, if you have an out-of-network plan or if your service does not meet Medicare’s medical necessity guidelines.) If you have active health insurance that does not cover your upcoming service, you have the following options available to you:
- Cancel the treatment and reschedule with a provider in your network.
- Reschedule for a similar treatment that may be covered by your insurance.
- Pay your portion of the charges and receive the service. This means you will be responsible for the entire cost if your insurance does not pay the bill.
Your insurance may require approval for certain services before you receive them to determine how much they will pay. Staff from our department will work to verify your insurance and obtain approval for your scheduled services. They will also try to determine if your insurance company will pay for your treatment. We will try to notify you prior to your scheduled service if your insurance has not agreed to pay for it. This does not happen often, but each insurance plan is different. Sometimes there can be a delay before approval can be obtained.
If pre-authorization has not been given prior to your service, we may need to reschedule your treatment. This will allow time for us to get pre-authorization. Without pre-authorization from your insurance, you will be responsible for the total cost. Payment will be required prior to service.
Patients will not be denied medically urgent services if they cannot pay. If you are unable to pay for a medically urgent service, please visit the Financial Counseling site to learn more about financial assistance programs and to see if you are eligible. This policy does not apply to services through the UTMB Regional Women’s Services & Pediatrics.
Thank you for choosing UTMB for your care. For more information, please visit our financial information and billing practices pages. Billing Customer Service: (800) 994-0363 / (409) 771-8811 Statements and balances due may also be reviewed on MyChart