- Authorization: Authorization is the approval of services. Authorization may be required for inpatient services, outpatient procedures, radiological services or any other service received within LRH.
- COB (coordination of benefits): This is when a patient has more than one insurance plan. This ensures that a double payment is not made to LRHC for services.
- Copayment: This is a fixed amount of money for the patient's responsibility of a claim or medical expense that must be paid by the patient.
- Deductible: This is the portion of the member's health-care expenses that must be met before your insurance coverage starts.
- Coinsurance: This is a member's coverage that limits the amount the insurance will pay for by a certain percentage. Any additional costs are paid by the member for the cost of the medical services provided. The patient may also need to meet their deductible first.
- EOB (explanation of benefits): This is a statement mails to a beneficiary explaining how the claim processed with their insurance company.
- Medicare: A federal insurance program providing health insurance for people typically aged 65 and older, for disables individuals, and for those with renal transplants. Medicare Part A covers hospitalization, skilled nursing facilities, home health care and hospice services. Medicare part B covers outpatient services and is a voluntary program.
Insurance coverage and pricing
Lake Region will submit claims to your insurance company and will do everything possible to expedite the claim. However, you should remember that your policy is a contract between you and your insurance company and you have the final responsibility of payment of your clinic/hospital bill.
In the event that LRH Contracts with your insurance company directly, your financial responsibility may be limited to deductibles, co-pays and/ or non-covered services.
If you receive certain tests or treatments while at LRH, you may receive bills from other physicians you did not see in person. These bills are for professional services rendered by these providers in diagnosing and interpreting test results while you were a patient. Other specialty areas may perform these services and are required to submit separate bills.
Please direct all questions for those bills to the providers billing office.