Common Insurance Questions

Do I need to let my insurance company know that I'm going to be in the hospital?

You should call your insurance company to verify benefits and determine if prior authorization or precertification is required for your procedure.


How do I know if my insurance company will cover my visit or certain services?

Every insurance plan – even ones under the same insurance company – is different. Contact your insurance company or your employer if you have questions about your coverage. Be as specific as possible as to what is scheduled to be done, such as “Caesarean section” rather than “surgery.”

Please note that the portion of the bill that insurance will pay is subject to your plan’s:

You may be asked to pay these amounts at the time the service is provided.


How do I know if my insurance company will cover services provided by all professionals (i.e. anesthesiologists, radiologists and pathologists)?

Ancillary service providers contract with insurance companies separately from Franciscan Alliance. These services may be out of network, depending upon your plan.

Every insurance plan – even ones under the same insurance company – is different. Contact your insurance company or your employer if you have questions about your coverage.

Please note that the portion of the bill that insurance will pay is subject to your plan’s: out-of-pocket maximum deductible copay coinsurance.


How do I follow up with my insurance company?

Call the phone number on the back of your ID card. It can help to have your explanation of benefits and/or your bill(s) from Franciscan Alliance and other providers with you when you make the call.


Does accept my insurance?

Franciscan Alliance contracts with a number of insurance companies, however we will accept any insurance and will file a claim for you. If you have questions, contact the Central Business office at 1-866-903-0436. Hours are Monday – Friday 8 am – 6:30 pm ET / 7 am – 5:30 pm CST.


What is the difference between my copay and coinsurance?

A copay is a flat amount that can be charged per hospital visit or stay, as defined by your benefit plan.

Coinsurance is a percentage of a bill that is approved by insurance company as the total amount allowed to be billed.


What is an adjusted amount or contracted allowance?

An adjustment or contracted allowance is the amount Franciscan Alliance agrees to discount your insurance carrier for services you receive. You are not billed for this amount.


What is an explanation of benefits?

An explanation of benefits, or EOB, is a letter from your insurance company that states how much the company will pay and how much you will owe.


Related Links