Billing and Insurance
As we work with patients to provide compassionate care, we must remain mindful of insurance and billing issues that may arise along the way. Capital Health participates with many medical insurance plans, but it is important to understand that your insurance policy is an agreement between you and your insurance carrier.
Many insurance plans require authorization and/or referrals prior to service. It is your responsibility to obtain any necessary referrals or authorizations needed. Please note that if referrals are required, you must obtain one referral for the hospital (Capital Health Medical Center – Hopewell) and one for the radiation oncologist. Your referring physician’s office should be assisting you with this process.
Coordination of Benefits
If both you and your spouse are employed and have insurance coverage through your employers, your policy is your primary coverage. Your spouse’s policy is considered secondary coverage and will be billed accordingly.
If you are having difficulty paying your hospitals bills due to lack of insurance or high co-pays, financial assistance is available for New Jersey residents who meet both income and asset criteria. Please call the Patients Accounts Department at 609-394-6023 to discuss eligibility criteria and financial assistance options.
Physician-related charges are not covered through the financial assistance program.
Frequently Asked Billing Questions
Did my insurance carrier pay for services?
Any reimbursement from your insurance carrier will be reflected on your statement. In addition, many insurance carriers send an explanation of benefits (EOB) to their subscribers to explain how their medical claim was processed.
Why didn’t my insurance carrier pay for the services?
Once a response is received from your insurance carrier and it has been determined that they will not cover a service, we will bill the patient. It is best to contact your insurance carrier directly for an explanation of the way your claim was processed and/or denied to obtain a clear understanding of your benefits and any limitations of your insurance coverage.
Why do I keep getting bills?
You are still receiving bills because your account is still open. After a claim for services is submitted, insurance carriers often request additional information, which can delay the payment of your outstanding account balance. The billing system automatically prints bills for all accounts with outstanding balances.
For any further billing questions, please call 609-303-4000.