Admissions/ Financial Services

Monroe Surgical Hospital

Admissions

When you are admitted to Monroe Surgical Hospital, you will need to present your doctor’s orders. If you are covered by a private insurance plan, Medicare, or Medicaid you will need to bring your insurance cards. We will be happy to file your health insurance claims for you. During admission, you will receive information on advanced directives and organ donations.

What a Hospital Bill Covers

The hospital bill covers the cost of your room, meals, 24-hour nursing care, laboratory work, test, medications, therapy and the services of the hospital employees. You will receive a separate bill from your physicians for their professional services.

As a courtesy to you the hospital submits bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company and that you have the final responsibility for payment of your hospital bill.

After your Insurance has paid your claim, our Patient Financial Service Department will send statements for payment of non-collected co-payment, co-insurance and or deductibles. You will receive three statements, two letters two phone calls over a 120-day period to obtain a payment or to make payment arrangements. If payment arrangements are not established and no payment is made during the 120-day period the account will be turned over to a collection agency. If you need an itemized statement or if you have any questions about your account after discharge, please contact our representative at 318-998-7601. Our financial counselors are available to help you by answering insurance related questions you might have. Just call ext 30634 after discharge.

Coordination of Benefits (COB)

Coordination of Benefits, referred to as COB, is a term used by insurance companies when you are covered under two or more insurance policies. This also can occur when you are involved in a motor vehicle accident and have medical insurance and automobile insurance.

Most insurance companies have COB provisions that determine who is the primary payer when medical expenses are incurred. This prevents duplicate payments. COB priority must be identified at the admission in order to comply with insurance guidelines. Your insurance may request a completed COB form before paying a claim and every attempt will be made to notify you if this occurs. The hospital cannot provide this information to your insurance company. You must resolve this issue with your insurance carrier in order for the claim to be paid.

Medicare

Monroe Surgical Hospital is an approved Medicare provider. All services billed to Medicare follow federal guidelines and procedures, Medicare has a COB clause. At the time of service you will be asked to answer questions to help determine the primary insurance carrier paying for your visit. This is referred to as an MSP Questionnaire and is required by federal law. Your assistance in providing accurate information will allow us to bill the correct insurance company.

Medicare deductibles and co-insurance are covered by most secondary insurance plans. If you do not have secondary insurance you will be asked to pay your co-pay, co-insurance and deductible at the time of service.

Advanced Beneficiary Notice (ABN)

For Medicare recipients: Only those services/tests/procedures that Medicare determines to be "reasonable and necessary" will be covered by Medicare; others may be denied. Prior to receiving any services/tests/procedures, we will provide for you an "Advanced Beneficiary Notice" which will inform you of those services which may not be covered.

Commercial Insurance

As a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number, and the correct mailing address for your insurance company.

For Self-Pay Patients

Monroe Surgical Hospital will offer you a discounted amount for the services to be rendered; this will be due prior to services being rendered.

If you are in need of financing, Monroe Surgical offers special rates through a financial service. Please ask us for an application or telephone number for assistance.

Monroe Surgical Hospital Managed Care Contracts

List updated as of: 3/19/2021

SMSO Anesthesia
Aetna
Blue Cross Blue Shield LA
CIGNA
Coventry
GEHA (PPO USA)
Gilsbar 360
Humana (PPO)
Humana Gold Choice
Louisiana Medicaid
Healthy Louisiana Plans (5):
- Aetna Better Health La
- AmeriHealth Caritas La
- Healthy Blue La
- Louisiana Healthcare Connections
- United Healthcare Community Plan La
Medicare
Multiplan/PHCS/ALC
NLPHO (Northeast LA Physician and Hospital Organization)
Novasys PPO
PPO Plus (Zelis)
Three Rivers Provider Network (TRPN)
Tricare
United Healthcare
Vantage Health Plans
Vantage Medicare
Verity Health Net
Workers’ Comp (Accepts as well)

IF YOUR INSURANCE IS NOT LISTED PLEASE CONTACT YOUR INSURANCE FOR CONFIRMATION

Additional Services Billed Separately

Anesthesia – SMSO Anesthesia, LLC – 318-998-6129
Pathologist – Dr. Jerry Liles or Delta Pathology – 800-897-6169
Radiology Associates – 318-387-3453
Your attending physician or any consulting physicians

Radiology Associates

Best Care/Beach Street/Fara
Blue Cross Blue Shield
CIGNA
First Health/Coventry
GEHA
Humana
LA Medicaid
Medicare
Three Rivers Network (TRPN)
Tricare Certified
United Healthcare
Vantage/Advantage
Verity Healthnet

NLPHO (Northeast LA Physician Hospital Organization)

Aetna
Arcadian Community Care Novasys (AR State Employees)
Assurant
Coventry/St. Francis
Health Plus
Insurance Systems (P&S)
PHCS
PPO Plus
Specialty Hospital

If your insurance is not listed please contact your insurance for confirmation.

Finance