Billing Frequently Asked Questions
Why did I receive a bill when I have insurance?
Even if your child is covered by your insurance, you may have out-of-pocket costs such as copays, co-insurance or deductible. We encourage families to contact their insurance company directly for more information about their specific benefits and what services and/or costs may not be covered.
If you believe you have met your out-of-pocket maximum and are being billed in error, please contact your insurance and have them review. Your insurance can submit a corrected payment if they applied a patient balance in error.
I received a bill but have new or re-instated insurance that should cover my visit. How do I get this updated?
You can add a coverage update request using your MyChart account at www.rchsd.org/mychart. Don’t have a MyChart account? Request access online by clicking New Account Request. If you do not wish to set up a MyChart account or you submit a MyChart coverage update request but do not see your self-pay balance updated please outreach to our Customer Service team to assist: 858-966-4912 for Hospital billing; 858-309-6290 for professional billing; or 858-502-1100 for primary care office billing.
Why did I receive multiple bills for the same date of service?
You may receive separate bills from Rady Children’s Hospital billing and professional billing departments, as well as affiliates of Rady Children’s that provide specialty services such as imaging equipment or anesthesia.
For example, if your child has an X-ray:
- The Hospital sends a bill for use of the equipment and clinical staff time.
- Radiology sends a bill for interpreting the X-ray.
- Your attending physician sends a bill for developing a treatment plan based on the results of that X-ray,
If you have questions about a specific bill, please call the phone number listed on that statement.
What is a hospital-based clinic?
A hospital-based clinic is an outpatient department of the hospital and may be located on the main Hospital campus or at other Rady Children’s sites that are remote from the main Hospital. At a hospital-based clinic, we can offer additional services that are not offered at a private physician office. After receiving service in a hospital-based department, you will receive two separate bills:
- One bill for physician/professional services rendered (examinations, consultations, test/x-ray readings, surgical procedures, etc.)
- One bill for the hospital/facility services (equipment, supplies, labs, X-rays, etc.)
Depending on your health insurance plan, you may or may not have higher out-of-pocket costs when receiving care at a hospital-based outpatient clinic. It is recommended that you contact your health insurance plan for more information on your specific benefits related to services received in hospital-based clinics.
What is a facility charge?
A facility charge covers the costs for running the hospital-based clinic facility itself, such as supplies, equipment, exam rooms and Hospital staff. Separate from the facility charge, a physician/professional charge covers your health care professional’s services, such as exams, consultations, tests/X-ray readings, surgical procedures, etc.
I am receiving bills and/or statement reminder calls for my child, but I am not financially responsible for their medical bills. How do I get this updated?
In the case that financial responsibility for your child’s medical bills is legally assigned to one of their guardians and can be demonstrated with a legal document such as a divorce decree or notarized court document please fill out this Guarantor Update Request Form and submit to firstname.lastname@example.org.
I already made a payment towards my balance, but this was not reflected on the statement I just received in the mail,
Please review the statement date in the top right-hand corner of your statement. If your payment was made after the statement date, it will be reflected on your next statement if there is still an outstanding balance. You can also check your current balance using your MyChart account at www.rchsd.org/mychart. Don’t have a MyChart account? Request access online by clicking New Account Request, use Pay as Guest to look up your account and view current balances.
I cannot afford to pay my balance. Do you offer financial assistance?
Yes, our financial counseling team is here to assist you. Please refer to our Financial Assistance page for more information. If you would like more information on financial assistance for care received at one of our primary care offices, please call our Children’s Primary Care Financial Services department at 858-502-1100.
How should I prepare for upcoming visits to avoid unexpected expenses?
- We encourage families to contact their insurance company to see what payment they may owe at the time of service, to determine if any referral is required to receive services at Rady Children’s and to determine if we are an in-network provider under your insurance plan.
- If you require assistance obtaining insurance, contact our financial counseling department at 858-966-4005 or visit the Covered CA website to see what health plans you may qualify for.
- To ensure we have accurate information on file for your health record, be sure to bring your current insurance card to every visit. Co-pays, previous balances and/or estimates are collected at the time of service.
Can I get an estimate for an upcoming service?
Rady Children’s provides a cost estimation tool for our patient families to determine a potential range of prices you may be charged for a specific service.
For questions on your estimate, please call:
- 858-576-1700 for Hospital estimates
- 858-309-6290 for specialty care clinic estimates
- 858-602-1100 for primary care clinic estimates