DECH Business OfficeBilling Information
The Patient Financial Services Department at Down East Community Hospital is comprised of four billing staff for hospital accounts, three billing staff for physician office accounts, two data processing employees, and the Patient Financial Services Director. The office is staffed Monday through Friday from 7:30 am until 4:30 pm. We are also closed on holidays.
We will be happy to bill your insurance company directly for services provided. If you have more than one insurance, we will bill them for any balance after your primary insurance has paid. If we need additional information from you in order to bill your insurance, we will contact you for this information. Sometimes an insurance company requires its insured to provide them with information directly, and will not accept the information from the hospital, such as any details surrounding an accident you may have had. It is very important that you respond promptly to any requests you receive from your insurance company for information.
We will send you a monthly statement for each
account you have at DECH that has a balance due from you. If you would like an itemized
copy of your bill, please call us to request one.
Some physician interpretation fees are billed separately. Your physician and other physicians with whom he or she consults with may also send you separate bills for their services. Payments for these services should be sent directly to their offices and not to DECH.
Hospital accounts can be discussed by calling 255-0284 for accounts with the last name beginning A-D, 255-0235 for accounts E-K, 255-0260 for accounts L-Q, and 255-0265 for accounts R-Z. Physician accounts can be discussed by calling 255-0434.
Down East Community Hospital participates with Medicare, Medicaid, Tricare, Cigna, Aetna, Anthem and many third party insurance companies. Some of those are Great West, United Healthcare, Harvard Pilgrim Healthcare, Patient Advocates, American Maritime Officers Benefit Plan, and American Postal Workers Union. Free Care is also available for qualifying individuals/families. Applications are available online under the Free Care link and by calling the Hospital Patient Accounts Department at the previously listed numbers. Prices of our most common inpatient/outpatient/ emergency room costs are available upon request per Dirigo guidelines. Visa, Mastercard, and Discover are accepted, and can be called in or entered through our secure website at www.dech.org. Estimates for hospital services are supplied from the PFS Director.
Vicki Brown, Patient Financial Services Director welcomes your questions, suggestions and comments and can be reached directly at 207-255-0460.
Frequently Asked Questions
Why do I receive two separate charges for one visit to my doctor's office?
This is a Medicare requirement. When a physician is part of a hospital/health care system (sometimes called Provider-Based or Hospital-Based Outpatient care), Medicare requires that the bill show separate charges for (1) physician care and procedures done in that office and (2) necessary facility charges for physician care.
My bill showed a Hospital Outpatient Lab Charge, but I never went to the hospital. Why?
Some lab tests are drawn in the physician office and then sent to the hospital or other facility for processing. The Hospital Outpatient Lab Charge is the cost of processing the test at the hospital.
What is Outpatient Observation?
If you spend the night at the hospital, it does not always mean that you are here as an inpatient. You may be here under observation
, which is actually an outpatient service. Observation allows your doctor to monitor your condition to determine if you should be admitted to the hospital or allowed to return home. Although you may not require admission to the hospital, you may still require additional monitoring, diagnostic testing and medication before you are able to go home. The doctor has up to 48 hours of observation time to determine if you will need to be an inpatient.
What are self-administered drugs? I got a bill for them.
During the course of any outpatient treatment, you may be given medication that is considered self-administered by Medicare. Medicare defines self-administered as medications that you could, in another setting, take yourself. The list of medications includes tablets, sprays, drops, inhalants and some injectable drugs. In order to remain compliant with Medicare regulations related to these drugs, hospitals are required to bill patients for these drugs. You will receive a bill from us following payment of our claim by Medicare. With few exceptions, most secondary insurances do not cover self-administered drugs.
I was asked at outpatient registration to sign an Advanced Beneficiary Notice (ABN). Why?
Medicare has certain guidelines it sets in order for certain outpatient diagnostic tests to be covered by them for payment. When you present to register at the hospital for outpatient diagnostic testing, your services will be screened for medical necessity.
If the diagnosis that your medical provider gives us does not meet their policy guidelines for payment, you will be asked to sign an ABN. The ABN will tell you the name of the test that is not covered, and the approximate cost of the test. The notice informs you that if you have the test, you will be responsible for paying for the test. Even though Medicare will not pay for the test, your physician believes that the test he has ordered will provide valuable information related to your continuing medical care. You may decide to have the test and pay for it, or you may decide to defer the test and have further discussion with your physician about obtaining a covered diagnosis, or alternate testing that may provide him/her with the same results.
Are there other services that Medicare will not pay for?
Not all services you may require or request from DECH may be covered. These may include, but are not limited to:
Dental services, such as when you come to the emergency room for a toothache or other dental pain
Routine or screening tests, except for those defined by Medicare as covered under preventative guidelines
Routine pregnancy care
Emergency room visits to have prescriptions refilled
Eyeglasses, except for one pair following cataract surgery
Lens implants at the time of cataract surgery that correct astigmatism or presbyopia
Physical exams (routine or yearly). Medicare will cover a one-time physical exam as outlined in their "Welcome to Medicare" guidelines.
Prescription drugs that are considered self-administered (see above)
Certain immunizations to prevent illness, such as zoster (shingles) vaccine. Flu and pneumonia vaccines ARE Medicare covered vaccines.