Do you have questions about your patient bill? We can help.
You'll find answers to some common questions below. If you have other concerns about billing and/or payments, please don't hesitate to give us a call at (808) 522-4013. Our Customer Service representatives are available Monday-Friday, 9:00 am – 4:30 pm or contact us with your questions.
Estimating your out-of-pocket costs:
Patients admitted to the hospital (inpatients) will receive separate bills for some services. Your hospital bill will include charges for your room, food, medical supplies and services, and any tests or procedures that you undergo, including X-rays.
Patients seen in a clinic or outpatient setting may receive separate bills for some services. Your clinic or outpatient bill may include charges for the use of the facility and any tests or procedures done at the time of your appointment, Many of the outpatient clinics or departments are considered hospital outpatient departments (also called provider-based) by Medicare.
Q: What does “provider-based” clinic mean?
A: “Provider-based” refers to billing for services rendered in a hospital outpatient clinic or location. This is a national model of practice for large integrated delivery systems (like Straub) where the hospital owns space and employs support personnel involved in patient care.
Q: Where are the Straub Provider-based clinics located?
- Straub Medical Center – Hawaii Kai Clinic
- Straub Medical Center – First Insurance Center Clinic
- Straub Medical Center – Kailua Clinic
- Straub Medical Center – Kaneohe Clinic
- Straub Medical Center – King Street Clinic
- Straub Medical Center – Mililani Town Center Clinic
- Straub Medical Center – Pearlridge Clinic
Q: Why do I receive 2 different bills for the same clinic visit?
A: Straub’s “Provider-based” clinics are required by Medicare to bill for services in two parts – one bill for the physician services (professional fees) and another bill for the hospital/facility resources and services that includes the technical staff, equipment and supplies involved in your care.
Q: Does this affect my co-pays or deductibles?
A: Depending on the clinical services being provided, additional out-of-pocket expenses for Medicare patients may be incurred in the “Provider-based” clinic.
Q: When is payment of my bill expected?
A: With the exception of co-payment amounts, the medical center expects full payment within 30 days of the billing date shown on your statement.
Q: What options do I have to pay my bill (check, cash, credit card)?
A: Straub accepts payments made by cash, check, money order, or credit card. We accept Visa, MasterCard, American Express, Discover and JCB. Payments can be made in the following ways:
- By Mail: Use the return envelope that came with your billing statement to make a payment by check, money order or credit card
- In Person Stop by our cashiers office or the Admitting/Registration office which is located on the ground floor of Straub. Also, payments can be made at any of our front desk areas through the clinics or hospitals.
- By Phone: Credit card payments can be made by calling Customer Service at (808) 522-4013.
Q: If I am unable to make payment in full what options do I have to pay my bill?
A: Patients who find it difficult to pay their bill in full within 30 days should contact a customer service representative at (808) 522-4013. Straub has several payment options available, including Financial Assistance.
Q: What if I find I can't afford to pay the bill I receive, are there any options?
A: Financial assistance is available for those individuals who are uninsured or underinsured or who are experiencing financial hardship. Eligible patients would be those who have limited financial resources to pay for an individual insurance policy and who do not qualify for Hawaii Medicaid. Your inability to pay for care should not prevent you from receiving medically necessary services.
To learn more about our Patient Financial Assistance Program, please contact our Customer Service Department at (808) 522-4013 on Oahu, (866) 266-3935 Neighbor Islands or stop by and meet with our Financial Counselors in the Financial Services Dept., located on the 1st floor of the Main Lobby.
Business hours: Monday-Friday 8:00 a.m. - 4:00 p.m.
Q: Why am I being billed when I have insurance?
A: Many insurance companies have amounts which the patient must pay. The amount may be for a co-insurance payment, deductible or an out of pocket expense (an expense not covered by your insurance provider).
If you have questions about why your insurance did not pay a portion of your claim, you should contact your insurance company directly. You may also receive a bill if your insurance company does not process our claims by their due date or if they deny coverage of your service.
If you receive a statement that does not show insurance processing, you should contact your insurance company to determine the reason for delay / denial.
Q: When do I make the co-payment and or deductible payment my insurance requires? Can I wait to be billed by Straub after my insurance processes the claim?
A: Co-payments are due at the time of service. If you are unsure of your co-payment responsibility please contact your insurance plan. If you are an inpatient, our financial counselors will obtain the deductible information at the time they check your eligibility. Straub expects co-payment amounts to be paid at the time of service. Please be prepared to pay your co-payment when you check in.
Q: If my insurance company has pre-certification, prior approval or notification requirements for specific services, am I responsible for completing this task?
A: The specific requirements and responsibility for completing pre-certification or notification depend on several things:
- Contract agreements between Straub and your insurance company, or
- The requirements as defined by your insurance or employer group plan
In many cases, Straub can assist with these requirements if we have a contract with your company.
However, if you have questions about your responsibility for completing these requirements, you should contact your insurance company directly. You may have to pay a higher deductible or coinsurance amount if these steps are not completed.
Q: How is a charge set for my services?
A: The charge for services included on your bill is based on many factors that vary from hospital to hospital, including the costs of buying medications, surgical equipment and other supplies; powering and maintaining hospital buildings; paying highly-trained healthcare workers; and purchasing up-to-date medical technology.
Charges are usually revised on an annual basis. These changes are made at the beginning of our fiscal year, which is July 1st. However, as technology and resource needs change, we may have to update our charges at other times during the fiscal year.
The machine readable file linked below was mandated by the Centers for Medicare and Medicaid Services (CMS) Hospital Pricing Transparency Ruling. For a more user friendly way to get an estimate of our services, you can find our convenient Patient Estimator Tool at https://mychart.hawaiipacifichealth.org/GuestEstimates.
Q: How much of the total charges do I have to pay?
A: Regardless of a hospital's charges, the government determines how much the hospital is paid for a service for those enrolled in a federal and/or state program like Medicare or Medicaid, and local negotiations determine how much a hospital is paid by those enrolled in commercial health plans, such as HMSA, HMAA, and UHA. Your insurance company determines your share of the amount paid for services based on your health plan benefits. The HPH Patient Estimator tool can provide you estimated patient share amounts for 300 of the most common services provided. You may also contact your insurance company, whether that is a commercial health insurance company, Medicare or a state Medicaid program.
For uninsured patients who do not qualify for financial assistance, Straub offers a discount off of its charges so uninsured patient can take advantage of similar discounts those the hospital offers to health plans. The charge for services provided is based on many factors that vary from hospital to hospital, including the costs of buying medications, surgical equipment and other supplies; powering and maintaining hospital buildings; paying highly-trained healthcare workers; and purchasing up-to-date medical technology.
The best way for patients to determine their out-of-pocket costs in advance of obtaining services is to contact their insurer, whether that is a commercial health insurance company, Medicare or a state Medicaid program. For a rough estimation of your out-of-pocket costs, click here to use our patient cost estimator tool.
Q: What is an Explanation of Benefits (EOB) or Explanation of Payment (EOP)?
A: These are documents showing a detailed listing of how your insurance company processed your claim or bill. An EOB or EOP is mailed by your insurance company directly to you.
Payment Policy for Uninsured Patients
For those without medical insurance, the cost of hospitalization or having a diagnostic test can be a financial challenge. We believe that patients should seek care when medically necessary without fear of related costs. To assist patients without medical insurance, we offer a discount in the following cases:
- The total charges for hospital services will be reduced by 40% when payment is received at the time of service or within 30 days of the receipt of your first bill.
- The total charges for hospital services will be reduced by 30% when payment is received within 90 days of the receipt of your first bill.
If payment of your bill is a financial hardship, please call Patient Accounts Customer Service at (808) 522-4013 to find out about our Patient Financial Assistance Program.