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Answers to Billing Questions

Frequently Asked Questions

Medical bills can be confusing or difficult to understand. We are here to help. Patient Financial Services representatives are available Monday through Friday from 8:00 am to 5:00 pm at (888) 71-CARLE, (888) 712-2753

What are Medical Fees?
Carle establishes a standard fee schedule, using a national database of fee information, which covers the cost of delivering services. Carle is not obligated to accept less than the billed amount for a service. Any unpaid balances will remain your responsibility.

What are Facility and Professional Fees?

Facility fees are those services charged for by the hospital. Professional fees are those charged for by physicians and other professional providers. What may appear to be a duplicate charge on your statement is a separation of the facility fee and the professional fee.

This billing model, called Provider Based Billing, complies with specific Medicare regulations. This is a nationally recognized billing model for integrated healthcare delivery systems such as ours.

Will insurance cover my services?
Carle encourages all patients to contact their respective insurance companies to verify coverage before their scheduled visits and/or procedures.

How do I change my information?
If there is a change in your name, address or insurance information, please notify us immediately by contacting (888) 71-CARLE, (888) 712-2753

How do I obtain an estimate for services?
You may at any time obtain an estimate of future services by contacting Patient Financial Services at (888) 71-CARLE, (888) 712-2753 or by visiting one of our Patient Financial Services locations.

Does Carle offer financial assistance?
Carle offers a number of options to assist you with paying your health care bills, including convenient payment plans and free or discounted health care.

Please review our Carle Financial Assistance Program at Carle.org/FinancialAssistance or contact Patient Financial Services for additional information.

Questions
Patient Financial Services representatives are available Monday through Friday from 8:00 am to 5:00 pm at (888) 71-CARLE, (888) 712-2753.

Statement FAQs

Carle's consolidated statement is for services rendered at several of our entities:

  • Carle Foundation Hospital, which includes Carle Home Care and Carle Hospice
  • Carle Physician Group
  • Carle Hoopeston Regional Health Center, which includes Carle Hoopeston Community Memorial Hospital and our Rural Health clinics.

Why do I receive separate statements from Carle?
You will receive separate statements for charges from: Carle Medical Supply, Arrow Ambulance, Home Infusion, Carle’s Extended Business Office or other third party agencies. In addition, you will receive separate statements for each guarantor in your household. If you are receiving separate statements for charges from Carle Foundation Hospital, Carle Physician Group and Carle Hoopeston Regional Health Center please contact us at (888) 71-CARLE, (888) 712-2753 and we will review your account.

How often will I receive a statement?
You will receive a statement every 28 days. Guarantor statements will continue until the account’s self-pay balance reaches a $0.00 balance or forwarded to a third party agency.

Did you receive my last payment? I do not see it listed on my statement.
Charges that are paid in full will not show on your statement. You can log into your MyCarle account to review your recent payment information.

Is my personal information secure with e-Statements?
Yes, all of your personal information is encrypted and password protected to ensure your personal information is secure.

What if I change my email address? 
Log into MyCarle and select the icon to view your statement or enroll in e-delivery, then click the "Profile" link. You can update your email address here so that all future notifications will be sent to the updated email address.

Who should I contact if I don’t receive my email notification?
If any questions arise please reference the "Contact us" section on the right side of your screen for the appropriate contact information.

When will I receive my e-Statement?
Your next e-Statement will be sent according to the existing statement cycle. E-delivery enables you to receive your statement on the actual statement date.

Why are there names of physicians on my statement that I haven’t seen?
Certain physicians help with your medical care even though you may not meet them. Commonly, these are the doctors who read your lab results, x-rays, and EKGs, as well as other diagnostic services.

Why is my statement for the full amount, and not for my monthly payment arrangement?
To reduce confusion on the statement, you are being presented with the total balance due. If you have a payment arrangement in place with Carle, you are expected to pay at least that amount.

Can I sign up for e-Statements?
Yes, you have the ability to have your Carle statement sent directly to your email address at no charge. With e-Statements you have the ability to view, print or save a copy right from your computer. The e-Statement is identical to the paper statement that you would have received in the mail.

How do I enroll to receive e-Statements?
Start by logging into your MyCarle account. If you don't have a MyCarle account, you may sign up at carle.org/MyCarle

Once logged into MyCarle, view your billing summary and click to view your Carle statements. This will redirect you to Carle's billing portal and once there you can click on "profile" to change your delivery methods. 

After you finish the enrollment process you will receive a validation email and will need to click on the link provided to activate your online account. If the link is not activated you will continue to receive paper statements.

What if I forget my password? 
When signing into MyCarle, click on the "Forgot Your Password" link under the password box. You will be prompted to enter your username and then you will receive a confirmation email. The email will contain a link to reset your password.

Payments

Payment Policy
The guarantor is responsible for payments for all charges for services received. Balances are to be paid in full by the due date on the first statement. Charges pending with insurance are the responsibility of the guarantor. Co-payments, deductibles and co-insurance are due at the time of service even though charges may be pending with your insurance for payment.

How else can I pay my balance?
If you choose not to pay online, you may send your payment along with your statement top to the payment address on your statement.

Carle accepts cash, check, Money Order, debit or credit cards (Mastercard, Discover Card or Visa). You may also pay at time of service at the registration desk or Kiosk. Payments are also accepted in person or over the phone with Patient Financial Services.

Can you automatically deduct my payment?
Carle offers recurring payment deductions from your checking or savings accounts, as well as from a qualified debit or credit card against the statement most recently received. New balances after the automatic deduction is established will not be included; therefore, you may need to set-up a new recurring payment.

Recurring payment arrangements must meet certain minimum monthly payment amounts and duration limits.

Recurring payments will not be set-up if the guarantor/patient does not have a valid email address. Recurring payment arrangements will not guarantee the withholding of an account from placement with a third party vendor. A declined payment may qualify the account for placement with a third party agency.

When will my payment be posted to my account?
Your payment will be processed and posted to your account within two - five business days.

If I have a credit balance on any of my Carle accounts, can it be moved to a different balance due?
If any payment results in a credit balance, we will transfer your overpayment to an open balance you have on another Carle account. If you do not have any open balances or charges pending for payment, we will send you a refund for your overpayment.

Can I pay my balance online?
You may pay your balance online by logging into your MyCarle account. You also have the ability to make a one-time payment online at carle.mysecurebill.com

Does Carle offer payment plans?
Total payment is expected for the guarantor’s portion at the time of service or receipt of statement. If you are unable to pay the full balance due, you may qualify for a monthly payment arrangement. Certain services may not qualify for an arrangement.

You may contact us at (888) 71-CARLE, (888) 712-2753 to discuss a payment arrangement. Please be aware that payment arrangements may be re-evaluated on a periodic basis. A missed payment may qualify the account for placement with a third party agency.

Do I need to specify which balances I want to pay?
No, Carle will split your payment across all of your balances due.

What if my payment is delinquent?
Self-pay guarantor accounts that are not paid in a timely manner will be referred to a third party agency, such as our Extended Business Office and/or a collection agency for additional collection activities.

Third party collection agencies may engage in Extraordinary Collection Activities (ECA) including:

  • Initiation of actions that require legal or judicial process
    • Civil Action
    • Placement of Liens
    • Wage Garnishments
  • Reporting adverse information about the guarantor to consumer credit reporting agencies or credit bureaus.

Provider-Based FAQs

The Following Are Outpatient Departments of the Hospital:

  • Clinical departments in the North and South clinic buildings on the Urbana main campus
    • Except Oral and Maxillofacial Surgery on North Clinic 1
  • All clinical departments in the main hospital or on the Urbana main hospital campus
  • Expanding Children’s Hearing Opportunities Program (ECHO)
  • Ambulatory locations at Mahomet, Monticello, Rantoul and Danville on Vermilion
    • Occupational Medicine at Danville on Vermilion, for worker’s comp visits only
  • Lab and Radiology services at Carle Danville on Fairchild
  • Carle Spine Institute
  • North Annex
    • Occupational Medicine at North Annex, for worker’s comp visits only
  • Champaign on Curtis
  • Champaign on Mattis
  • Urbana on Windsor
  • Ambulatory location for Orthopedics and Sports Medicine
  • Plastic Surgery Center
  • Clinical departments at Carle Outpatient Services at The Fields
    • Except Oral and Maxillofacial Surgery

You will be charged for any services performed by your physician, and receive separate charges from the hospital for facility services. Depending on your insurance, there may be an additional co-pay or co-insurance (one for the physician and one for the hospital) for one visit. If you have secondary coverage, any additional co-insurance and deductible may be covered by your secondary insurance. This billing model, called Provider Based, complies with specific Medicare regulations and is a national model of practice for integrated healthcare delivery systems such as Carle.

What is Provider-Based Status?
Provider Based status is a status sanctioned by Medicare for hospitals and clinics. It is a national model of practice for integrated healthcare delivery systems like Carle that includes hospital and physician offices. Simply put, it means that physician offices are departments of the hospital. One of the benefits of having Provider-Based status is the opportunity to participate in the Federal 340B Drug Purchasing Program.

Will I have to pay an additional fee for my next visit?
There will be a facility charge for an office visit that will then be applied to the patient's insurance plan and be billed accordingly. The patient's insurance plan coverage will be applied to both bills and the remaining balances will be billed to the patient - one bill for hospital facility fees and one for physician services. This is no different than the way Carle currently bills for other hospital based services like the Emergency Department, Therapy Services, Lab services and surgical procedures.

What if I'm confused about the bills I get in the mail?
If you have questions about your bills, please call Carle Patient Financial Services at (888) 71-CARLE, (888) 712-2753

Why did Carle convert to this model for most of its physician office locations?
The rising cost of health care and lower reimbursements prompted Carle to make this change for its physician office locations. The Medicare-approved Provider Based model ensures Carle is compensated fairly for services provided and allows Carle to participate in a federal drug purchasing program that will help lower the total cost of care.

Like all Illinois hospitals, Carle is experiencing significant reductions in reimbursement.

Carle is taking proactive steps to ensure high-quality care is available to the residents of east central Illinois now and in the future. By converting to the provider-based model, Carle is ensuring it is reimbursed fairly for services it provides. By participating in the 340B Drug Purchasing Program, Carle is trying to reduce the supply cost of providing care to patients.

How will this affect my next visit? 

Provider Based billing will not change your covered services, but it may affect your copayments and deductible.

What if I'm having trouble paying my medical bills?
Carle has a number of options for those struggling to pay medical bills, including payment plans and free or discounted health care through the Carle Financial Assistance Program. If you'd like to hear more on these options, call Carle Patient Financial Services at  (888) 71-CARLE, (888) 712-2753

What is the 340B Program?
By converting most of our physician practice locations to provider-based status, Carle can participate in a program called 340B that extends discounts to hospital providers on some drugs it purchases for use in the hospital outpatient setting. The Federally-designed 340B Program enables approved nonprofit health care organizations to stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. The discounts available through this program will help reduce overall expenses for drug supplies.