Frequently Asked Questions About Insurance

Should I bring my insurance card with me?

Yes, the information on your insurance card is needed to file a claim with your insurance company or companies. When you register we will ask for information about your insurance coverage and have you sign a form authorizing your insurance company to assign benefits to UPMC Pinnacle Hanover.

You should also be aware that your insurance card contains important information about the co-pay amounts you are responsible for on different types of service. If possible, please be sure to review your health insurance handbook prior to your trip to the hospital.

Remember, the registration process goes much faster when you bring complete insurance information with you.

Why do I have to show my insurance cards every time I come to the hospital?

To better serve our patients, we like to make sure that we have accurate and up-to-date information on file.

How will I know if a service is covered by my insurance?

Policies vary widely on which procedures, services or items an insurance company will cover. Because policies are often customized, we do not always know what your policy covers. In order to maximize your health insurance benefits, it is very important that you familiarize yourself with the policies and benefits outlined in your health insurance handbook.

Questions to ask your insurance company:

  • Am I covered for (service/item name)?
  • What are my benefits for (service/item name)?
  • Do I need a referral or prior-authorization for (service/item name)?
  • Is the provider an “in-network” provider?

What is pre-authorization and what does this mean?

Pre-authorization is the approval by your insurance company to proceed with surgery or a special procedure.  You must verify that this is done by the physician who will perform the procedure. Obtaining pre-authorization does not guarantee that your insurance company will pay the bill.

Can you provide me with an estimate for a certain procedure?

Yes, but we will need the following information from you:

  • A CPT (Current Procedural Terminology) code, which can be obtained from your physician
  • The name of the procedure

Who can I talk to if I have questions about my hospital bill?

Customer service representatives are available Monday through Friday, 8 a.m. to 4:30 p.m. to answer questions about your hospital bill, insurance, and other concerns. They can be reached at 717-316-7877 or 1-800-673-2426 ext. 7877.

Does UPMC Pinnacle Hanover submit bills for patients who have insurance with which we do not contract?

UPMC Pinnacle Hanover bills all insurances if complete billing information is provided.

Can you explain the bill I received from my doctor?

Unfortunately, we do not have access to physician bills. Please call your physician's office directly.

Why did I receive a bill from both the hospital and the doctor?

The hospital and the doctors bill separately for their services.

Why am I getting a bill when I have not been to the hospital?

You may receive a bill from the hospital even though you were not a patient. If your doctor performed lab work or a biopsy for you in his office and sent it to the hospital for analysis, you will receive a bill from the hospital for the service. You will also receive a bill from your doctor for his services.

Why am I getting another bill when I already paid?

The statement may have been mailed before the payment was posted to your account. Call us at 717-316-7877 or 1-800-673-2426 ext. 7877 to verify. Please provide your account number if available, your name, and your date of birth, and we will verify that the bill was paid.

Can I combine my accounts and make payment arrangements?

If you have more than one account with UPMC Pinnacle Hanover, you may combine them for payment arrangements after appropriate insurance payments have been received. All accounts must have a current balance and must not have been placed with a collection agency or have legal action.

What financial assistance is available if I have difficulty paying my bill?

You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. Financial assistance includes discounts for services provided to patients who are uninsured or underinsured. For more information, please contact a financial counselor at 717-316-6972, 717-316-6973, or 1-800-673-2426 for free, confidential assistance.

Why am I receiving a refund check?

There may have been an over payment to your account. Either you paid too much on the account and/or your insurance paid at a later date and covered some of what you already paid.