Click on a ‘Question’ title in the list below to see the answer.
How do I pay my bill online?
Patients will need to register for the CCHC FMH patient portal in order to view statements and pay their bill online. You can register here or by asking for a registration invitation at the front reception desk at any CCHC practice. Once connected to CCHC, you will be able to pay your bill online.
I have questions regarding the CCHC FMH patient portal. Who do I ask for assistance during and after regular business hours?
I have questions about my account, who do I contact?
Please call our Central Billing Office at (252) 514-2061. When calling, please have your account number, office location, physician’s name, and copies of your insurance cards available so that we will be better able to assist you.If my CCHC provider does not participate in my insurance plan, how can I get CCHC to accept my insurance? CCHC participates with several major insurance plans that provide health insurance coverage. CCHC does not contract with insurance carriers on an individual basis. CCHC evaluates insurance plans based on their customer service, reliability, reimbursement rates, enrollment, claims processing abilities and responsiveness.
If CCHC files a claim with my insurance company that is not covered, can CCHC change the insurance billing code so it is covered?
If CCHC makes an error filing an insurance claim, we will correct the error and re-file the claim. However, to change an insurance billing code just to get your insurance to pay the claim is fraud; we will not do that. CCHC files insurance claims using “Current Procedural Terminology”, which is published by the American Medical Association and is used by all insurance carriers to pay claims. It is very important that patients understand what services are not covered under their insurance. This is especially important for patients seeking preventive, annual physical examinations, and screening services, which may not be covered by Medicare and other insurance plans.
Why am I receiving a bill when I have insurance?
Each insurance company and each plan has different coverage options. For information on what is covered and what is not covered, please contact your human resource person or your insurance company. You may be billed for all non-covered services.
You are responsible for copays, deductibles, and coinsurance outlined on your insurance card and in your plan document. You may receive a bill for these amounts if payment was not collected at the time of service. If you feel your insurance has not paid a claim correctly, please contact your insurance company. If you have additional questions after talking with your insurance company about your claim, please call our Central Billing Office at (252) 514-2061 for assistance.
What is the difference between a copay, coinsurance and deductible?
Copay is a set amount you pay at each office visit. Copay’s can vary depending on the physician’s specialty and type of care, such as Urgent Care.
Coinsurance is the percentage of covered expenses you must pay in addition to the deductible. For example, your plan document details that the insurance will pay 80% of all covered services after your deductible has been paid. You would then be responsible for the remaining 20% as coinsurance.
A deductible is the initial dollar amount you must pay out-of-pocket before an insurance company pays its portion. Deductibles vary and patients may have more than one deductible to meet per year.
Who can I talk to about making payment arrangements?
Please contact our Central Billing Office at (252) 514-2061. They will be happy to assist you in setting up payment arrangements.
Why do I have a credit balance when I have Tricare for Life?
When Tricare for Life was first implemented, Tricare did not have a record of the patients with additional insurance coverage. If you are continuing to see a credit on your account, please contact Tricare’s DEERS at 1-800-538-9552. If you inform Tricare of all of your insurance coverage, they will correct the problem.
What is "Surprise Billing"?
“Surprise billing” is an unexpected medical bill which happens when you cannot control who is involved in your care. Learn more about when this can happen and your protections against unanticipated medical charges.
When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that is not in your health plan’s network.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care—similar to when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
If you have an emergency medical condition and receive emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may receive after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you receive services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections.
If you receive other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are never required to give up your protections from balance billing. You also are not required to receive care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing is not allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
- Cover emergency services without requiring you to obtain approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
What is a self-pay good faith estimate?
You have the right to receive a Self-Pay “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Self-Pay Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Contact Coastal Carolina Health Care, P.A.
1020 Medical Park Ave.
New Bern, North Carolina 28562
Post Office Box:
P.O. Box 12248
New Bern, NC 28561
T: 252-514-6685 | 252-514-2061