Pre-Certifications & Insurance Claims
Understanding your medical insurance coverage and taking the proper steps is important. Always call your plan administrator or insurance representative to find out what requirements you must follow before undergoing a medical procedure.
Pre-certification is the authorization of medical service by your insurance carrier. Typically, your physician will pre-certify your procedure or visit. However, in most cases, you are ultimately responsible.
If pre-certification is not performed, your insurance company may reduce your level of benefits or simply deny benefits completely. Always check to see if pre-certification is required for the hospital service you are to have performed and, if it is, verify that your physician has taken care of this step.
Filing Insurance Claims
Patient Accounting will file insurance claims for services you receive. If at any time you wish to discuss your bill, please contact customer service at 225-924-8106, Monday-Friday, 8:00 AM-4:00 PM. You may also come to our office Monday-Friday, 8:00 AM-4:00 PM at 8850 Airline Highway.
To ensure accurate filing of your insurance claim, please do the following:
- Prior to your arrival, review your insurance carrier's requirements for pre-certification/pre-authorization. Failure to follow your carrier's stated protocol could result in reduced benefit payments.
- Present your insurance card at the time of registration.
While you are at the hospital, you will probably receive services from doctors who will be interpreting tests ordered by your doctor, or providing other specialized services to you. You may or may not receive a visit from these doctors. These doctors will bill you for the services they provide separately from your doctor and the hospital.
Services provided by other professionals not employed by Woman's Hospital, including but not limited to the following, will be billed separately.
- Emergency medicine
These providers may or may not be participants in your insurance plan. Please contact your insurance carrier for coverage determination. Specific inquiries regarding professional billing for these services may be directed to:
- Anesthesia: Louisiana Anesthesiology Group, LLC, 225-929-7600
- Laboratory: Pathology Group of Louisiana, 225-769-9993
- Neonatology: Infamedics, 225-928-2555
- Perinatal: Maternal-Fetal Medicine Center, 225-924-8338
- Radiology: Medical Business Consultants, 225-296-0041 ext. 121
Many changes have occurred during the past few years in the healthcare and insurance industries. Patients are often restricted to what physicians they can see and what hospitals they can use.