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Answers to Billing Questions

Frequently Asked Questions

Medical bills can be confusing or hard to understand. We’re here to help. Our Patient Financial Services representatives are available Monday through Friday from 8 a.m. to 5 p.m. at (888) 71-CARLE, (888) 712-2753.

We can answer questions about the Carle Health “consolidated bill” – which includes charges for Carle Physician Group, Carle Foundation Hospital, Carle Hoopeston Regional Health Center, Carle Richland Memorial Hospital, Carle West Physician Group, Carle BroMenn Medical Center and Carle Eureka Hospital. 

Patients in the Greater Peoria area – who get a bill with charges from Carle Health Methodist Hospital, Carle Health Pekin Hospital, Carle Health Proctor Hospital, or any other Carle Health locations or clinics – can contact us at (844) 849-1260. Note: Some of the answers to the billing questions below may not apply to patients in the Greater Peoria area due to the recent change of ownership. If you ever have questions, give us a call.

What are "medical fees"?

You’ll be charged “medical fee(s)” – these pay for the cost of delivering your service. Carle Health has created a “standard fee schedule” of costs, based on costs at similar places (and for similar things) around the country. Carle Health isn’t forced to accept less money than what they bill you – you’ll be responsible for paying any unpaid amounts.

What are "facility and professional fees"?

You might see two different types of fees on your bill. “Facility fees” are the costs charged by the hospital. “Professional fees” are the costs charged by the doctors (and other professional medical providers who care for you). What may look like a double/repeated charge on your bill is actually correct – one is the “facility fee,” and one’s the “professional fee.”

This type of billing is called “provider-based billing.” It’s used nationwide in many healthcare systems like ours. 

Will insurance pay for my services?

Please call your insurance company before your visit/procedure. They can help answer your questions. You can usually find their phone number on your insurance ID card.

How do I change my information?

If there is a change in your name, address or insurance information, please call us right away at (888) 71-CARLE, (888) 712-2753.

How do I obtain an estimate ("best guess") for services?

Call us at (888) 71-CARLE, (888) 712-2753; visit one of our Patient Financial Services locations; or use our online tool. Learn more here.

Does Carle Health offer financial help - to help me pay for my costs?

Carle Health offers a number of options to help you pay your healthcare bills, including convenient payment plans and free or discounted care.

Read about our Financial Assistance Program at carle.org/FinancialAssistance or call us at (888) 71-CARLE, (888) 712-2753 for more information.

I still have questions.

Still have questions? Call us Monday through Friday from 8 a.m. to 5 p.m. at (888) 71-CARLE, (888) 712-2753. We’re happy to help.

Statement FAQs

The Carle Health “consolidated bill” (also called the “consolidated statement”) is for medical services you may get at any of these locations:

  • Carle Foundation Hospital, which includes Carle Health Home Care and Carle Health Hospice.
  • Carle Physician Group clinics and locations.
  • Carle Hoopeston Regional Health Center, which includes Carle Hoopeston Community Memorial Hospital and our Rural Health clinics.
  • Carle Richland Memorial Hospital.
  • Carle West Physician Group.
  • Carle BroMenn Medical Center.
  • Carle Eureka Hospital.
  • Carle Health Methodist Hospital.
  • Carle Health Pekin Hospital.
  • Carle Health Proctor Hospital.
Why do I get multiple bills/statements from Carle Health?

Not all Carle Health locations, groups and businesses share the same billing system. Because of this, you’ll get separate bills/statements for charges from: Carle Medical Supply; Arrow Ambulance; Home Infusion; Carle Health Methodist, Pekin and Proctor hospitals and associated clinics (for services provided before 12/2/23); the Carle Extended Business Office; or other third-party agencies. Also, you’ll receive separate bills/statements for each “guarantor” (person legally responsible for paying the medical bills) in your household. For questions, please call the phone number that’s on the bill/statement.

How often will I receive a statement?

You’ll get a statement every 28 days. You’ll keep getting statements until the account’s self-pay balance reaches a $0.00 balance or is forwarded to a third-party agency.

Why am I getting electronic bills/statements (rather than a statement by mail)?

You’re sent “e-statements” (electronic bills/statements) unless you tell us you’d like them to come by mail. With e-statements, you can view, print or save a copy right from your computer. The e-statement is the exact same as the paper statement. If you want to get your statement by mail, please call us at (888) 71-CARLE, (888) 712-2753.

When will I receive my e-statement?

You’ll get your next e-statement on the actual statement date – you won’t have to wait days for it in the mail because it’s sent to you electronically. We send statements on a regular cycle.

Is my personal information secure with e-statements?

Yes, all of your personal information is safe, protected and encrypted. 

What if I change my email address?

If your email address changes, you need to update your email address with us so we can send all future messages to your new email. To do this, log into your MyCarle account and click the icon to view your statement or enroll in e-delivery; then follow the "Profile" link to view your information and update your email address. 

Who should I contact if I don’t receive my email notification?

If any questions come up, please log into your MyCarle account and look at the "Contact us" section on the right side of your screen – here you’ll find the contact information to best reach us.

What if I forget my password?

When signing into MyCarle, click on the "Forgot password?" link under the password box. You’ll be asked to enter your username, and then you’ll get an email sent to you. This email will have a link to reset your password.

Why is my statement for the full amount, and not for my monthly payment arrangement?

The statement lists the total balance due. But if you have a payment arrangement with Carle Health, you only need to pay that amount at this time, not the total balance that’s listed.

Did you receive my last payment? I do not see it listed on my statement.

If any of your charges are paid for in full, they’ll not show up on your statement any more. But you can always log into your MyCarle account to double-check your recent payments.

Payments

Payment Policy

The “guarantor” (the person legally responsible for paying the medical bills) is held responsible for payments for all charges for the medical services received.

Balances must be paid in full by the due date on the first statement.

The guarantor is also responsible for any charges that are “pending” (waiting action) from the insurance company.

Copayments, coinsurance and deductibles – costs that the guarantor themselves pays out of their own pocket, based on the specifics of their insurance plan – are due to Carle Health at the time you receive your medical service, even though some charges may still be pending with your insurance company.

How else can I pay my balance?

If you don’t want to pay online, you can mail your payment – along with your statement top – to the payment address that’s listed on your statement.

You can also pay in person – at the time of your medical service – at the registration desk or kiosk.

Or you can make an easy payment by phone, 24/7, by calling (888) 71-CARLE, (888) 712-2753.

Carle Health accepts cash, check, money order, and debit or credit cards (Mastercard, Discover or Visa).

Can you automatically deduct my payment?

Carle Health offers automatic payment plans – where we can deduct your payment automatically from your checking or savings accounts, or from a qualified debit or credit card – for the statement you’ve most recently received. Note: New charges/balances you get after you set up the automatic payment are not included; you’ll probably need to set up a new automatic payment for these.

To use an automatic payment plan, you must pay at least a certain amount every month. There are also time limits for how long you get to pay off the entire balance.

You can’t set up an automatic payment plan if you don’t have an email address.

Automatic payment plans will not guarantee the withholding of an account from placement with a third-party agency. 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 to five business days.

If I have a credit balance (an overpayment) on any of my Carle Health accounts, can I move it to a different Carle Health account to help pay for that balance?

Yes. We can transfer your overpayment to an open balance you have on another Carle Health account. If you don’t have any open balances or charges that need paying, we’ll send you a refund for your overpayment.

Can I pay my balance online?

Yes. You can pay online by logging into your MyCarle account. You can also make a one-time payment on the Pay My Bill page.

Does Carle offer payment plans?

Full payment for your charges is expected at the time of your medical service or when you get your bill/statement. If you can’t pay the full amount due, you may qualify for a monthly payment arrangement.

Call us at (888) 71-CARLE, (888) 712-2753 to talk about a payment arrangement. Please know that certain services might not qualify for a payment arrangement, and that even if you set up an arrangement, it can be reviewed, changed or ended by Carle Health later on. Also, a missed payment can qualify the account for placement with a third-party agency.

If I have multiple balances to pay, do I need to let you know - specifically - which balances I want my payment to go to?

No. Carle Health will split your payment across all your balances that are due.

What if I don't pay my balance in a timely manner?

Self-pay guarantor accounts that aren’t 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 agencies may use “extraordinary collection activities” (ECAs) like:

·   Starting actions that require the legal or judicial process.

·   Lawsuits.

·   Placement of “liens” – in other words, seeking the right to keep possession of your property or belongings until you pay your balance.

·   “Wage garnishments” – in other words, seeking the right to take the money you earn (for example, from work) to pay your balance.

·   Reporting negative information about you/the guarantor to consumer credit-reporting agencies or credit bureaus.

Outpatient Department Billing FAQs

The Following Are Outpatient Departments of Carle Foundation Hospital:

  • The following are outpatient departments of Carle Foundation Hospital:

    ·         Clinical departments in the North and South clinic buildings on the Urbana hospital campus.

    ·         Except Oral and Maxillofacial Surgery on North Clinic 1.

    ·         All clinical departments in the main hospital or on the Urbana hospital campus.

    ·         Expanding Children’s Hearing Opportunities (ECHO) program.

    ·         Ambulatory locations at Mahomet, Monticello and Rantoul.

    ·         Occupational Medicine at Carle Danville at The Riverfront, for worker’s comp visits only.

    ·         Lab and Radiology services at Carle Danville at The Riverfront.

    ·         Carle Spine Institute.

    ·         North Annex.

    ·         Occupational Medicine at North Annex, for workers' comp visits only.

    ·         Carle Champaign on Curtis.

    ·         Carle Champaign on Mattis.

    ·         Carle 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.

    The following are outpatient departments of Carle BroMenn Medical Center:

    ·         Radiation Oncology and Radiology at Carle Cancer Institute Normal.

    ·         Carle BroMenn Family Health Clinic.

    ·         Center for Wound Healing and Hyperbaric Medicine.

    ·         Carle MRI in Bloomington.

    ·         Cardiology, Cardiovascular Surgery and Pediatric Cardiology.

    ·         Pulmonology.

    ·         Vein Clinic in Normal.

    ·         Family Medicine in Bloomington, Fairbury and Le Roy.

    ·         Endocrinology.

    ·         Neuroradiology.

    ·         Rheumatology.

    ·         Pediatrics in Bloomington.

    ·         Bariatrics at Carle BroMenn Outpatient Center.

    The following are outpatient departments of Carle Health Methodist Hospital (CHMH)

    *Effective December 2, 2023

    ·         Breast and High-Risk Breast Clinic at CHMH Atrium.

    ·         Cardiovascular Services at CHMH Atrium.

    ·         Psychiatry at CHMH.

    ·         Sleep Lab and EEG at CHMH Atrium.

    ·         Suspicion of Cancer Clinic.

    ·         Perinatology at CHMH.


In these locations, you’ll be charged for any services done by the doctor (or other medical provider), and you’ll also receive other, separate charges from the hospital for facility services.

Depending on your insurance, you may have one copay (or coinsurance) cost for the doctor/provider and a separate one for the hospital, for a single visit.

If you have secondary insurance coverage, any additional copay/coinsurance and deductible may be covered by your secondary insurance.

This type of billing is called “provider-based billing.” It’s used nationwide in many healthcare systems like ours.

What is "provider-based status"?

“Provider-based status” is a national model of practice for healthcare systems, like Carle Health, that include both hospitals and doctors’ offices. Put simply, it means that doctors’ offices are labeled as departments of the hospital. One of the pluses of having provider-based status is being able to participate in the 340B Drug Pricing Program (see more below).

This type of billing – “provider-based billing” – is new to me. Will I notice changes or see anything that looks different from what I’m used to?

Depending on your insurance, you might notice a change in your copays or coinsurance (what you pay out of your own pocket – rather than what insurance pays). Changes will not impact patients covered by Medicaid.  

You’ll continue to get one single bill for the care you get at Carle Health, but multiple charges will be listed on this bill – the charges from the hospital and those from the doctors/providers. This is no different from the way Carle Health bills for other hospital-based services, like those you get in the Emergency Department, at Therapy Services, and for lab services and surgeries.

What if I'm confused about the bills I get in the mail?

If you have questions about your bills, please call Carle Health Patient Financial Services at (888) 71-CARLE, (888) 712-2753.

Why does Carle Health use “provider-based status” and “provider-based billing”?

This helps us continue to meet the healthcare needs of our communities, now and into the future. It makes sure we get fair payment amounts for the medical services we provide and it lets us take part in a drug-pricing program run by the government (see more below), which helps us lower the total cost of care.

By using the “provider-based” model, Carle Health is ensuring it can keep providing charity care and community benefit programs for those who need it most – and keep bringing the highest level of care to our communities for years to come.

What if I'm having trouble paying my medical bills?

Carle Health offers a number of options to help you pay your medical bills, including convenient payment plans and free or discounted care.

Read about our Financial Assistance Program at carle.org/FinancialAssistance or call us at (888) 71-CARLE, (888) 712-2753 for more information.

What is the 340B Drug Pricing Program?

It’s a program run by the U.S. government that gives discounts to hospitals on some drugs they buy for use in hospital outpatient locations. It helps nonprofit healthcare systems like Carle Health stretch limited resources as far as possible, to help more patients and provide more services.