About Your Bill |
Advance Directives |
Billing and Insurance |
Common Terms |
Customer Service |
Frequently Asked Questions |
Insurance Plans
At UT Southwestern Medical Center we realize that seeking medical help for an illness or undergoing a comprehensive examination can be stressful. We want to help ease that stress by answering some of the more common questions about the billing and insurance part of the patient’s visit. For additional questions, please call us at 214-645-0600 or toll-free at 866-648-2455 or e-mail us.
What do I need to bring with me when I come to UT Southwestern?
- A photo ID such as a driver’s license. We require this for the patient’s protection.
- Medical documentation requested by the patient’s physician. Example: X-rays, lab results, pathology reports and medical records such as immunization records.
- The patient’s current insurance card (for both primary and secondary insurance coverage).
- An insurance referral or authorization from the patient’s primary care physician, if required by the insurance plan. Referrals are usually required for Aetna HMO, CIGNA HMO, HMO Blue and Parkland Health First.
- Method of payment for any copayments, deductibles or coinsurance.
- OPTIONAL:
- Copy of current advance directive. UT Southwestern accepts written advance directives. Patients with advance directives, such as a Directive to Physician and Family of Surrogates (Living Will) or Medical Power of Attorney, should ask that the advance directive be forwarded to the Health Information Management Department.
- List of current medications that includes the dosage and how often taken.
What health plans are accepted?
UT Southwestern accepts most major insurance plans. View a list of the insurance plans we currently accept.
Not all UT Southwestern faculty providers participate in all plans. Please contact the UT Southwestern clinical practice or hospital where the patient wishes to be scheduled to verify that that the patient’s plan is accepted.
Do I need a referral to see a health-care provider at UT Southwestern?
Patients may make an appointment with a UT Southwestern specialist without a doctor’s referral. However, coordination of the patient’s health care may be improved when his or her doctor provides us with information regarding the patient’s condition prior to the initial visit. For this reason, some UT Southwestern specialists may request information or a referral from the patient’s doctor before seeing the patient.
Patients do need an insurance referral from their primary care physician, if it is required by their insurance plan. It is the patient’s responsibility to obtain a referral if required. If unsure whether an insurance referral is needed for the patient’s visit, contact the insurance company’s member service department. The phone number should be on the insurance card.
Common plans that require insurance referrals are Aetna HMO, CIGNA HMO, HMO Blue and Parkland Health First. Medicare patients do not need insurance referrals.
My insurance plan requires a copayment. Will I be required to pay the copayment when I check in for my appointment?
Yes. Copayments are collected at the time the services are provided. For the patient’s convenience, we accept cash, checks, Visa, MasterCard, Discover and American Express.
The patient should also be prepared to pay for services not covered by insurance. We may ask for payment in full at the time of service for cosmetic care, elective care or supplies not covered by insurance.
How will I find out how much I owe?
The patient will receive monthly statements from UT Southwestern Medical Center. This may include two different statements: one for hospital services (UT Southwestern University Hospitals and Clinics), and one for physician, health-care provider services (UT Southwestern Medical Service Plan).
UT Southwestern University Hospitals and Clinics: This bill is for the services provided at UT Southwestern University Hospital and Clinic facilities. Charges for room, surgical suite, equipment, medications, diagnostic testing and supplies for treatments or procedures conducted in any of the areas below appear on this bill.
- Annette Simmons Stereotactic Treatment Center
- GI Lab
- Heart & Lung Transplant
- Imaging & Lab Services
- Kidney, Liver & Pancreas Clinic
- Outpatient Surgery Center
- Sleep and Breathing Disorders
- University Hospital Physical Medicine & Rehabilitation
- UT Southwestern University Hospital - Zale Lipshy
- Ut Southwestern University Hospital
The first statement provides the details of services received and the amount billed to the insurance company. Follow-up statements are sent after insurance payments are made and there is a balance due from the patient.
Please direct any questions regarding billing, charges or denied claims to 214-645-4500 or toll-free 1-866-590-2198 or e-mail us at MyBill@utsouthwestern.edu.
Please send payments to:
UT Southwestern University Hospitals and Clinics
P.O. Box 849928
Dallas, TX 75284-9928
UT Southwestern Medical Service Plan: This bill is for the services provided by UT Southwestern physicians, physician assistants and nurse practitioners. Statements from UT Southwestern Medical Service Plan itemize the services received, the amount paid by insurance and the amount the patient owes.
Please direct any questions regarding billing, charges or denied claims to 214-645-0600 or toll-free 866-648-BILL (2455) or e-mail us.
Please send payments to:
UT Southwestern Medical Service Plan
P.O. Box 845347
Dallas, TX 75284-5347
The patient may also receive statements from laboratories, imaging facilities, ER physicians or other professionals for services received during the visit. It is a legal requirement for these providers to submit separate bills for their services. We do not have access to their billing information. Please contact them directly with any questions about those statements.
How is my insurance company billed?
UT Southwestern submits all items covered by insurance to the patient’s insurance company. It is very important that the patient provides current and accurate insurance information. Usually, the insurance company will pay us directly. If the patient has insurance, he or she needs to assign the insurance benefits to UT Southwestern. UT Southwestern bills the patient’s insurance only when benefits are assigned.
If we have a contract with the insurance company, we will honor their allowances for the patient’s charges.
We file supplemental insurance if the information is provided and benefits are assigned at the time of service.
The patient is responsible for the deductible, copayments, coinsurance and non-covered services. These amounts will appear on the patient’s monthly UT Southwestern Medical Center statements.
Who is responsible for paying the bill?
The patient is financially responsible for the services received at UT Southwestern Medical Center. Even though the patient has health-care insurance, he or she is responsible for any part of the bill the insurance plan does not pay.
If the patient has an HMO, PPO and other commercial insurance, he or she is responsible for all copayments, deductibles and coinsurance at the time of services.
If the patient has Medicare but does not have supplemental or secondary insurance, he or she may also be responsible for copayments, deductibles and coinsurance at the time of service.
If the patient does not have insurance or if the patient received non-covered services, he or she is expected to pay at the time of service. Patients are also eligible for a self-pay discount. Written policies on Discounting for Self Pay and Uninsured Patients are available upon request.
I want to receive service from a UT Southwestern provider, but I know my insurance will not cover it. Is there any way to find out how much the service will cost?
Yes, UT Southwestern staff can give an estimate. The patient may have to visit a UT Southwestern physician first to find out the specific services needed. Please remember that charges may vary based upon the medical condition. We also may not be able to schedule services until the estimate is complete
Patients without insurance are eligible for a 25 percent discount for medically necessary services. Medications and supplies are excluded.
My provider has ordered a specific test or procedure. Do I need to receive authorization from my insurance company before I can have this test/procedure done?
If our doctors prescribe care that needs prior authorization, we will gladly work with the patient to obtain the required authorizations and pre-certifications.
Services that frequently require authorizations include: advanced diagnostic imaging services (such as MRI, CAT and PET), inpatient hospital stays and durable medical equipment (DME).
It is best to direct specific coverage questions to the insurance company’s member service department. The telephone number should be on the insurance card.
I cannot pay my whole bill at one time. Can I make payment arrangements?
In most cases full payment of the bill is due 25 to 30 days after the patient receives a statement showing a balance is due. Our customer service representatives will work with the patient to arrange a payment plan, if special circumstances prevent the patient from making a full payment.
How can I find out whether my insurance has paid?
When the insurance company responds to the claim, the patient receives an Explanation of Benefits (EOB). The EOB contains detailed payment information, including the portion of the bill that the patient must pay. Questions about the EOB, or disputes with the amount paid, should be directed to the insurance company. We are happy to share any information we receive from the insurance company.
What if there is an error in my bill?
If the patient believes that his or her bill is incorrect, please call us at 214-645-0600 or toll-free at 866-648-2455. We will be happy to discuss any concerns.
Why do I have a hospital (facility) charge when I was seen in the clinic only?
The UT Southwestern Clinics listed below are classified as hospital-based facilities. Charges for services such as surgical suite, use of specialized equipment, medications, diagnostic testing and supplies for treatments or procedures are billed by UT Southwestern University Hospitals and Clinics:
- Annette Simmons Stereotactic Treatment Center
- GI Lab
- Heart & Lung Transplant
- Imaging & Lab Services
- Kidney, Liver & Pancreas Clinic
- Outpatient Surgery Center
- Sleep and Breathing Disorders
- University Hospital Physical Medicine & Rehabilitation
Why do I need to call my insurance company if they do not pay the bill?
The insurance company has the most accurate and up-to-date information about the policy and claim. They can tell the patient if the procedure or service received is covered by the policy. The insurance company can also verify that they received and processed the claim. If they have not received the claim, please contact us:
UT Southwestern University Hospitals and Clinics
214-645-4500 Toll-free 1-866-590-2198
UT Southwestern Medical Service Plan
214-645-0600 Toll-free 1-866-648-BILL (2455)
We make every effort to collect payment from the insurance company, but we may need the patient’s assistance to resolve any concerns or to obtain payment from the insurance company.
I have a question that is not on this list. How do I get answers?
Please ask us! Patient questions are our concern, so patients should feel free to ask a doctor, nurse and clinic staff any questions they may have. Our staff can help with any questions about medical care, insurance benefits and appointment scheduling.
For further assistance with hospital billing questions, please contact Patient Financial Services at 214-645-4500 or toll-free 800-590-2198. Service representatives are available Monday–Friday 8 a.m.–4 p.m.
For questions about physician services performed in the UT Southwestern University Hospitals and Clinics (see table above), regular office visits, in-office procedures and diagnostic test interpretation call Account Services at 214-645-0600 or toll-free 866-648-2455 (BILL). Service representatives are available Monday–Friday 8 a.m.–6 p.m.
Patients may also e-mail questions to MyBill@utsouthwestern.edu.
The billing staffs can answer questions about insurance payments, assist with insurance appeals, provide copies of statements and establish payment arrangements.
