Billing & Insurance

Billing Questions

Today’s healthcare environment is challenging for both consumers and providers.

People have to make tough choices about treatment and procedures at the same time considering their ability to pay or their source of payment for services.

We understand that billing and payment for healthcare services can be confusing and complicated. 

Knowing your insurance policy is vital to receiving the maximum benefits possible. Failure to meet your insurance requirements may result in partial or complete claim denial and/or a higher co-payment or deductible.

We request that you pay at the time of registration any:
  • Insurance Co-payments – Co-pays are the flat dollar amounts an insurance plan requires the insured person to pay for each type of service. Hospital services that typically have co-pays, include but are not limited to Emergency Department visits, hospital outpatient stays, outpatient services, blood or blood products, etc.
  • Deductibles – Deductibles are fixed dollar amounts an insurance company requires the insured person/family to pay (“meet”) each year before the insurance company starts to pay a higher share of the medical bills.
  • Co-insurance – Co-insurance is the percentage of the bill that is the patient’s share. Co-insurance only applies to charges that are “covered” by that insurance company. Once the insurance company’s out of pocket (stop loss) threshold is met, co-insurance percentage will not apply.
  • Non-covered Charges – Patients are responsible for paying for services that their insurance company considers “non-covered.”

Financial Assistance

If your health insurance coverage benefits do not adequately cover your medical expenses, we can work with you to arrange a manageable payment plan.

Our financial counselors are trained to assist you in meeting your financial obligations. We offer a variety of payment plans and prompt payment discounts. 

We accept all major credit cards.

Financial counselors can also assist you in applying for charitable or public assistance programs for which you may be eligible. 

This service is provided to you at no cost. However, your cooperation is essential to successfully qualify for these programs. You are still financially responsible for the medical services until you are qualified for one of the programs.

You should call the member services phone number on the back of your insurance card to make sure ACMH Hospital is in your plan’s network. 
Understand the services, tests and appointments that are covered by your insurance and your specific plan.
Be prepared for any upfront out of pocket costs – these costs could be associated with:
  • Co-payments
  • Co-insurance
  • Deductible applied by your insurance company
For specific questions on any financial responsibility applied to you by your insurance (copayment, deductible, coinsurance) you should call the member services phone number on the back of your insurance card. 
Insurance plans that are out of ACMH Hospital’s network could mean higher out of pocket costs for the patient. 

We Are Here to Help:
As a courtesy to patients and their families, ACMH Hospital submits claims to most insurance carriers. 
To insure proper and prompt processing of your claim, it is important that all current insurance information be presented at the time of pre-registration and/or admission. 
Please have a copy of your insurance card and your driver’s license or other form of identification with you when you check in.

ACMH Hospital staff is available to assist you in understanding your hospital insurance benefits. 
Estimates of your financial responsibility are based on the accuracy of this information. The insurance benefit information provided by your insurance plan is based on the latest information they have available. Please remember that your insurance plan benefits are a contract between you, your employer and your insurance company. It is in your best interest to know and understand your benefits. 

If your insurance plan requires the medical services scheduled to be pre-certified or pre-authorized, ACMH Hospital will attempt to obtain such approval from the insurance plan or the entity responsible for utilization management. 
Failure to meet your insurance requirements may result in partial or complete claim denial or a higher co-payment or deductible, and you may be responsible for the remaining balance.

AARP
Adagio Health Vouchers
Aetna/Coventry
  • Advantra (Medicare)
  • Aetna Choice PPO
  • Aetna
  • Aetna Better Health (Medicaid)
  • Aetna CHIP
  • Aetna Medicare
  • Coventry Medicare
  • First Health
GEHA
  • Health America
  • First Health
  • Amish
Auto Insurance
  • Auto claims should be open and not in litigation to be accepted for services
Champ VA
Cigna
Community Care Behavioral Health
Federal Black Lung
Gateway Advantage – Medicare
Highmark Blue Cross/Blue Shield
  • Blue Cross PPO 363
  • Blue Cross PPO 378
  • Blue Cross Anthem (Medicare)
  • Blue Cross Blue Card
  • Blue Cross Choice
  • Blue Cross Classic
  • Blue Cross Community
  • Blue Cross Community Blue Medicare
  • Blue Cross Direct
  • Blue Cross Federal
  • Freedom Blue (Medicare)
  • Security Blue (Medicare)
  • Blue Cross Keystone
  • Blue Cross Out of Area Plans
  • WPEE Blue Cross
HealthSCOPE Benefits
Hospice Plans
Humana Medicare
Humana
LIFE Armstrong (Lutheran SeniorLife Products) – with prior authorization
Mail Handlers Benefit
Medicaid
Medicare
  • Medicare Part A (inpatient admissions only)
  • Medicare Part B (outpatient services only)
Medicare Supplement Plans – such as AARP, Mutual of Omaha, Aetna Senior Products, etc.
Mutual of Omaha
New Era Insurance
PSERS/HOPSRural Carrier Benefit Plan
Spectra East, Inc.
TRICARE
TRICARE For Life
UMWA – United Mine Workers Assoc.
United American Insurance
United Healthcare
  • All Savers
  • United Healthcare Community Plan
  • United Healthcare Community Plan for Kids
  • United Healthcare Choice Plus
  • United Healthcare Golden Rule
UPMC
  • UPMC Individual Advantage – Premium Network
  • UPMC For Life (Medicare)
  • UPMC For Kids
  • UPMC For You
  • UPMC For You Advantage (Medicare)
  • UPMC – Standard/Premium Network Plans
  • UPMC Business Advantage HMO
  • Panther Gold HMO
  • My Care Advantage – HMO/PPO (level 2 only)
VA
Value Behavioral Health
Workers Compensation Insurance
  • Workers comp claims should be open and not in litigation to be accepted for services. Authorization may be required for certain appointments.

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Patient Financial Counseling
Please contact our Patient Financial Counseling Office at 724-543-8525 or 724-543-8521 with any questions prior to your visit. The office is open Monday through Friday from 7:00am until 4:30pm. 

Mail correspondence to:     
ACMH Hospital
Attn: Financial Assistance
One Nolte Drive
Kittanning, PA 16201