Osceola Regional Health Center is here to help you navigate the often-confusing world of insurance benefits.
In-network or out?
To receive full insurance benefits, some health plans require you to go to an “in-network” or “participating provider” doctor or hospital. In an emergency, go to the nearest hospital. Your insurance company may either cover these costs or ask that you go to an “in-network” hospital if it is safe to do so.
If you choose to go to an “out-of-network” hospital in a non-emergency, you may have to pay a larger deductible or a greater part of your bill. Be sure to know the “out-of-network” rules of your insurance plan.
Some insurance plans require you to call for approval before you receive certain services. Be sure you know your insurance company’s coverage requirements. On elective procedures, always ask both your physician’s office and your insurance plan about coverage.
We will complete and file your Medicare claims for you. You will receive an explanation of benefits from Medicare stating what has been paid. Remaining amounts will either be paid by your Medicare supplement, or become your responsibility.
Our policies and procedures align with Medicare’s regulations on hospitalization. This means that upon admission or in the event of extended hospital stays, patients may be issued a denial of coverage if their condition does not meet Medicare approved criteria for hospitalization. It this occurs, we will work with you to find other resources to provide the appropriate level of care.
If you qualify for Medicaid, it is your responsibility to let our business office know immediately. Evidence of eligibility must be provided on the day of your visit. Medicaid claims must be processed within four months from the date of service. Without this information from you, we are unable to process your claim and will bill you personally.
High blood pressure greatly increases your risk of heart disease and stroke. If your blood pressure is below 120/80 mm Hg, be sure to get it checked at least once every two years, starting at age 20. If your blood pressure is higher, your doctor may want to check it more often.