Billing Information
Billing Information
- Overview
- Online Bill Payment
- Help Paying Your Bill
- Policies
- Process
- FAQ
- Financial Assistance
- CMS Open Payments
Our billing policies
Know your insurance plan’s provisions and requirements. Be sure to read your benefits handbook and question your insurance company on any areas that are unclear.
Please call your insurance company for authorization of hospital services if it is a plan requirement. If authorization is not obtained in the timeframe your policy dictates, you may be heavily penalized, or services may be denied by your carrier.
Hoag will bill both your primary and secondary insurance plans.
With verified eligibility and receipt of any outstanding monthly share of cost, Hoag will bill Medi-Cal or CalOptima/MSN for authorized services.
Once insurance payment(s) or denial(s) have been received, you will be billed for any deductible, co-insurance, co-pay or non-covered amounts.
Those patients with no insurance coverage will be expected to make payment at the time services are rendered.
Price quotes for services are estimates only. Your bill will indicate services as ordered by your physician.
Itemized statements are available upon request.
Medi-Cal and Medical Safety Net (MSN) representatives are available for those patients needing information regarding financial assistance programs. A Hoag Hospital representative can be reached at (949) 764-5564.
Deposits – If you have acceptable verified medical benefits, no deposit is required for most procedures. Please bring your insurance card and/or insurance form at time of registration. Otherwise, the hospital will require a deposit. The hospital accepts Visa, MasterCard, Discover and American Express. Deductibles, co-insurance & co-pays will be collected at time of service.
Customer service representatives are available Monday through Friday from 8:30 AM – 4:00 PM to provide you with estimates of charges for upcoming surgical procedures as well as most deposit requirements.
Newport Beach: (949) 764-8271
Irvine: (949) 517-3167
The patient accounting staff is available Monday through Friday 8:30 AM – 4:30 PM (except holidays) to provide customer service to our patients regarding services at Hoag Hospital. Please call (949) 764-8400.
Hoag’s billing contact information
Please see link below to view Hoag’s Billing Guide, which includes commonly asked billing questions and answers. You can also call us at (949) 764-8400 with your questions so we can help you.
Our patient accounting department can also provide billing for services rendered at the following Hoag facilities:
Hoag Breast Care Center
Hoag Family Cancer Institute
Hoag Health Centers (*radiology services only)
Hoag Surgicare
Important links
1
Hoag's Billing Guide
Download guide2
Shoppable Service
View estimates3
Your Rights & Protections Against Surprise Medical Bills
Learn morePatient financial services customer service
Hoag Newport Beach Office
Call: (949) 764-8400 to speak with a patient financial services representative.
Email: Patient financial services at PFS@hoag.org
Hours: Monday – Friday, 8:30 AM – 4:00 PM (closed on holidays)
Walk-In: Customer service representatives are located in the Cashiers Office on the Newport Beach hospital campus.
Hoag Irvine Office
Call: (949) 764-8400 to speak with a patient financial services representative.
Email: Patient financial services at PFS@hoag.org
Hours: Monday – Friday, 8:30 AM – 4:00 PM (closed on holidays)
Walk-In: Customer service representatives are located in the Cashiers Office on the Irvine hospital campus.
Patient Financial Services Written Correspondence and Payments: Hoag Business Center, 2975 Red Hill Ave, Suite 200, Costa Mesa, CA 92626
Price Line
To receive estimated pricing information on procedures or surgeries please contact:
Hoag Newport Beach: (949) 764-8271
Hoag Irvine: (949) 517-3167
Email: Cashier@hoag.org
Price Transparency
The Centers for Medicare and Medicaid Services (“CMS”) requires hospitals to post details about the pricing of items and services they offer. Hospitals utilize a chargemaster system and create a chargemaster report, listing charges for each item or service provided to a patient. These charges are for items and services provided at Hoag and will appear on the patient bill. The chargemaster is updated from time to time.
The chargemaster rates do not necessarily reflect the amount that a patient will pay for the services rendered. Government insurance plans such as Medicare and Medicaid do not pay the chargemaster rates, but rather have their own set rates which enrolled hospitals are obligated to accept. Commercial insurance plans pay rates agreed to by both the plan and the hospital. Patients without government or commercial insurance may contact the hospital prior to a procedure to discuss charges, alternative pricing and payment terms.
Download the machine readable disclosure file for standard hospital charges relevant to the CMS guidance.
Maternity Cash Payment & Financial Information
For those patients who do not have insurance coverage, or elect to not utilize their insurance, the following rates apply and include the hospital fees for the mother and the baby.
Financial Counselors
To discuss financial assistance programs please call (949) 764-5564.
No Surprises Act
Please click here to learn more about your rights and protections against surprise medical bills.
Online bill payment
If your bill looks like the sample bill below, you have the option of paying online using Hoag Connect MyChart:
Help paying your bill
Hoag Hospital’s Financial Counseling Department offers free financial screenings for people who do not have health insurance and cannot pay their hospital bill, as well as patients who do have insurance, but are unable to pay their portion of the bill that insurance does not cover.
Our Financial Counselors will determine your eligibility for Medicare, Medi-Cal, or other government assistance in paying your medical bills. Patients’ ineligible for government assistance may still qualify for the Financial Assistance Program, discounts, or charity programs available through Hoag Hospital.
How to Apply?
Please contact our Financial Counselors immediately after discharge or completion of services by calling (949) 764-5564 or by e-mail at FC@hoag.org.
If you have questions or would like to receive a financial assistance application form, please contact us: by telephone at (949) 764-8413, by visiting our Financial Assistance Page, or by visiting in person at one of the following locations:
Hoag Hospital Newport Beach Cashier’s Office One Hoag Drive, Newport Beach, CA 92662 | Hoag Hospital Irvine Cashier’s Office 16200 Sand Canyon Ave, Irvine, CA 92618 | Patient Financial Services Attn: Charity Care Specialist 2975 Red Hill Ave, Suite 200, Costa Mesa, CA 92626 |
Hours: Monday through Friday 8:30am to 4:30pm or by email at FC@Hoag.org | Hours: Monday through Friday 8:30am to 4:30pm or by email at FC@Hoag.org | Hours: Monday through Friday 8:30am to 4:30pm or by email at PFS@Hoag.org |
Hospital Bill Complaint Program
If you believe you were wrongly denied financial assistance, you may file a complaint with the State of California’s Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.
Health Consumer Alliance
The Health Consumer Alliance (HCA) is an independent consumer assistance program that offers free assistance over-the-phone or in-person to help people who are struggling to get or maintain health coverage and resolve problems with their health plans. HCA can assist you with applying for coverage such as Medi-Cal, Hospital Presumptive Eligibility, private insurance, or Covered California.
Department of Managed Health Care
Department of Managed Health Care (DMHC) educates consumers about their health care rights, resolves consumer complaints against health plans, helps consumers understand their coverage and assists consumers in getting timely access to appropriate health care services. The DMHC Help Center provides direct assistance in all languages to health care consumers through the Department’s website, HealthHelp.ca.gov, and a toll-free phone number, (888) 466-2219.
The Hospital Bill Complaint Program
The Hospital Bill Complaint Program is a state program which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program: HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.
No Surprises Helpdesk
To learn more about No Surprise billing protections for consumers contact 1 (800) 985-3059 or visit www.cms.gov/nosurprises/consumers
Confidentiality
We understand that the need for financial assistance can be a sensitive and deeply personal issue. We are committed to maintaining the confidentiality of requests, information, and funding.
We are committed to making information about the Hoag Financial Assistance Program available in the communities we serve in a manner that is easy to understand.
In addition to English, this summary, Hoag Financial Assistance Program Policy, and Hoag Financial Assistance Application form, are available in other languages available below. If you need help in your language, please call (949) 764-8400.
Patients with disabilities may access this notice in an accessible alternative format including, but not limited to, large print, braille, audio, and other accessible electronic formats by contacting the Admissions Office at (949) 764-8275 or (949) 517-3161.
Audio Recording
Billing process
Medicare
We bill Medicare and your secondary insurance following receipt of Medicare’s payment. Once your secondary insurance has been billed, you will receive periodic statements advising you of the balance due.
PPO/EPO/HMO (Managed Care)
We will bill your contracted insurance carrier. You will not be billed while the claim is processing with your insurance carrier. Upon receipt of their payment or denial, we will bill you for co-insurance, deductibles, and non-covered services.
Medi-Cal/CalOPTIMA
With verified eligibility and receipt of any monthly share of the cost, we will bill MediCal/CalOPTIMA for authorized services.
Medical Safety Net (MSN)
With verified eligibility and receipt of Co-Pay, we will bill MSN for authorized services.
Group/Indemnity
Group and indemnity insurance will be billed for charges incurred. You will receive periodic statements advising you of the balance due.
Cash
Those patients with no insurance coverage will be expected to make payment at the time services are rendered.
Balance billing-patient responsibility
If you are unable to pay for your portion of your bill in full, please contact us to arrange mutually acceptable payment options.
Contact us by phone at (949) 764-8400 or email at PFS@hoag.org
Common billing questions
Yes. Hoag Hospital will bill for hospital services. Please remember to present your current insurance information at time of registration.
Yes. Upon receiving payment or denial from your primary insurance, we will gladly bill your secondary insurance for any balance remaining.
If at any time you wish to receive an itemized statement of your charges and payments, please call our Patient Accounting department and a representative will order one to be mailed to you. This process usually takes two or three days.
Please call our Patient Accounting department at 949-764-8400. Our representatives will be happy to help you.
Yes. By accepting assignment, Hoag Hospital agrees not to bill the patient for any charges Medicare disallows. However, we do bill patients for deductibles, co-insurance amounts and noncovered services.
All patient deductibles, co-insurance, co-payments and non-covered services are due and will be collected prior to, at the time of service, and/or once your insurance company processes and pays your claim. Many of the insurance companies send you an exclamation of benefits which explains how they process the claim and what is considered patient liability and owed by you. We except cash, check, Visa, MasterCard, Discover and American Express.
You will be billed separately by each physician involved in your care. These physicians usually include your surgeon, assistant surgeon, anesthesiologist, radiologist (if X-rays are performed), pathologist (if pathology specimens are examined), cardiologist, and any physician who may interpret an exam ordered by your doctor.
Coverage varies. Please call your insurance company, plan administrator, insurance broker or the benefits department (sometimes human resources) of your employer with any questions regarding coverage.
The balance after your insurance has paid reflects any remaining deductible or co-insurance amount. Your insurance company is best able to help clarify your amount due. Most insurance companies provide you with an Explanation of Benefits to help answer any questions.
A separate accounting number is generated for each outpatient date of service and each inpatient admission. This enables us to bill for specific charges and diagnosis relating to your care for that date of service, and enables your insurance company to apply the proper benefits. Exception: For recurring outpatient accounts such as physical therapy or radiation therapy, a separate account is generated monthly.
Financial Assistance and Charity Care
Our mission as a nonprofit, faith-based hospital is to provide the highest quality health care services to the communities we serve.
What is the Patient Financial Assistance Program?
Hoag Hospital’s Financial Counseling Department offers free financial screenings for people who do not have health insurance and cannot pay their hospital bill, as well as patients who do have insurance, but are unable to pay their portion of the bill that insurance does not cover.
Our Financial Counselors will review your eligibility for Medicare, Healthy Families Program, Medi-Cal, or other coverage offered through the California Health Benefit Exchange, California Children’s Services program, other state- or county-funded health coverage, or charity care. If you already have coverage through one of these programs please notify our Financial Counselors immediately. Patients ineligible for government assistance may still qualify for discount or charity programs available through Hoag Hospital.
How and When to Apply
Please contact our Financial Counselors immediately after discharge or completion of services by calling 949-764-5564 or by e-mail at FC@hoag.org. We can assist with your application and provide the applications for Medicare, Healthy Families Program, Medi-Cal, or other coverage offered through the California Health Benefit Exchange, California Children’s Services program, other state- or county-funded health coverage. You may also be referred to www.OCGOV.com for local assistance.
If you lack, or have inadequate, insurance, and you meet low- and moderate-income requirements, you may qualify for discounted payment or charity care. Please remember that access to necessary health care is not affected by eligibility for financial assistance. Hoag Memorial Hospital is committed to treating all those who come to us for care.
Provider Listings
Hoag’s financial assistance policy applies only to services billed by Hoag. None of the providers delivering emergency and medically necessary care, other than Hoag Hospital, are covered by Hoag’s financial assistance policy. Download a list of provider’s providing emergency or other medically necessary care in Hoag’s facilities that are not covered by Hoag’s financial assistance policy here.
Providers that do not follow Hoag’s financial assistance policy may have their own financial assistance policies, so please contact the provider directly if you have questions regarding their policies.
You may also apply directly for the above programs by accessing their website directly
Supporting Charity Application Documentation
It is important that you complete and submit the completed Financial Assistance Application along with all the required documents.
Two (2) recent pay stubs or the most recent 1040 tax returns for each wage earner, including all applicable schedules and attachments.
Copy of your most recent cancelled rent check, lease agreement or mortgage payment or a written statement from a family member or friend who is providing your room and board and/or income.
Return Options: by fax (949) 764-7031, email PFS@hoag.org, or mail at the following address:
Patient Financial Services (Attn: Charity Care Specialist), 2975 Red Hill Ave, Suite 200, Costa Mesa, CA 92626
Confidentiality
We understand that the need for financial assistance can be a sensitive and deeply personal issue. We are committed to maintaining the confidentiality of requests, information and funding.
Questions: For more information regarding Financial Assistance, please contact Hoag Patient Financial Services at (949) 764-8400. We are available Monday through Friday from 8:00 AM to 4:30 PM. We are closed weekends and all major holidays.
Hoag CMS Open Payments
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here: openpaymentsdata.cms.gov
The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.
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