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Hospital Bills and Insurance

Hospital Bills and Insurance

All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the hospital’s billing procedures and charges. If you have questions about your insurance coverage, a member of the Patient Accounts Department will contact you or a member of your family while you are here.

If You Have Health Insurance
We will need a copy of your identification card. We also may need the insurance forms, which are supplied by your employer or the insurance company. You will be asked to assign benefits from the insurance company directly to the hospital.

If You Are a Member of an HMO or PPO
Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your health care plan and their services may not be covered. You may have limitations on services.

If You Are Covered by Medicare or MaineCare

We will need a copy of your Medicare card to verify eligibility and process your claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments also are the responsibility of the patient. MaineCare also has payment limitations on a number of services and items.

If You Have No Insurance

A representative from the Credit Office will discuss financial arrangements with you. A hospital representative may be available to assist you in applying for MaineCare or other government assistance programs.

If You Cannot Afford to Pay

The hospital provides free care to residents of Maine whose income falls below stipulated guidelines. You may also qualify for partial assistance, based on our sliding fee scale. Information is needed in order to process your claims. If you believe that you qualify for free care, call the hospital Credit Office at 454-9219. Before providing free care, you will be asked for income information and to verify that you are not covered under any insurance or assistance program. Services that are not medically necessary are not eligible for charity care.

Patient Financial Services Policy
Financial Assistance Guidelines
CRH Financial Assistance Guidelines Income Table
CRH Financial Assistance Plain Language Summary
Calais Regional Hospital Financial Assistance Application with Instructions 

Your Hospital Bill

The hospital will submit bills to your insurance company and will do everything possible to expedite your claim. But you should remember that your policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital bill. We have several payment options available to assist you in paying your bill.

Your bill reflects all of the Hospital services you receive during your stay. Charges fall into two categories: a basic daily rate, which includes your room, meals, nursing care, housekeeping,; and charges for special services which include items your physician orders for you, such as x-rays or laboratory tests. Hospital-based physician charges will also appear on your bill. If you have certain tests or treatments in the hospital, you may receive bills from physicians you did not see in person. These bills are for professional services rendered by these doctors in diagnosing and interpreting test results while you were a patient. Pathologists, radiologists, and other specialists perform these services and are required to submit separate bills. If you have questions about these bills, call the number printed on the statement you receive from them. If you have questions about financial/insurance issues call Patients Accounts at ext. 207 or 153. It is the policy of Calais Regional Hospital to treat all customers requiring medical care without regard for ability to pay and to assist our customers in arranging for settlement of their account obligations.

Healthcare Costs

There are often financial concerns involved when receiving medical care.   Cost estimates are available by contacting the Patient Accounts Office at 207-454-9352.    For a list of current prices for the most common services/procedures at CRH click here.   If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular healthcare service provided at this facility. If you are not covered by health insurance, you are strongly encouraged to our Patient Financial Services office at 207-454-9351 to discuss payment options prior to receiving services from our healthcare facilities, as posted prices may not reflect the actual amount of your financial responsibility.