Do you have questions about your hospital 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.
Estimating your out-of-pocket costs:
Q: What is the hospital bill for? Is this my only bill for these medical services or can I expect to receive others?
A: When you receive a hospital bill for services from hospital departments, the bill includes many costs: facility charges, equipment, supplies, nursing services and other support personnel, etc. You may expect to receive bills for medical services from the hospital as well as from the physician and/or other providers who supplied medical services.
Q: What other bills should I expect? Can you tell me about them?
A: Because of government regulations, most hospital-based physicians and specialists bill their services separately from the hospital. The separate bill will be from your personal physician, surgeon or other independent supplier of medical services.
The chart below gives examples of medical services that require the attention of a physician who will send a separate bill for payment:
|If you have:||You will also receive a bill from:|
|Emergency room service||The emergency room physician|
|X-rays taken||The radiologist|
|Certain lab tests||The pathologist|
|Surgery||The anesthesiologist and surgeon|
|A visit by your personal physician||Your personal physician|
If you have a question regarding a physician's bill, please call their office.
Q:Why did I receive a bill from Wilcox for lab services when I never visited the hospital?
A: The Wilcox laboratory routinely performs tests on specimens for physicians statewide. Therefore, you may receive a hospital bill for laboratory services that your physician ordered, although you have not been to the hospital yourself.
Q: What is the best way to be certain that my insurance is paying its share of these costs?
A: The best way is to present your insurance card and all insurance information at the time of registration. A new account is usually set up for each visit to the hospital. This allows your insurance company to track any deductibles and your co-payments. If your card is not presented and the insurance does not cover these costs as a result, you will be responsible for full payment.
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.
Q: Why didn't my insurance pay charges for a routine check-up?
A: Most insurance companies, including Medicare, will not pay for routine physical check-ups. If you have screening tests, such as a chest X-ray, blood sugar test, a Pap smear or other similar screening test, your insurance may not pay. Contact your insurance carrier if you have questions about your coverage.
Q: Do you bill my insurance carrier or must I notify them?
A: Wilcox will bill your insurance company for you. Due to the numerous differences in insurance benefits available, the hospital does not guarantee your insurance will pay. If your insurance does not pay within 30 days, you may be asked to pay the account balance. If you furnish complete information at registration, we will file your secondary insurance also.
Q: What can I do if I am unemployed and uninsured?
A: You may apply for healthcare coverage. Both the admissions office and the business office will have Med Quest applications available for you. Applications need to be completed and submitted to the Med Quest office in Lihue within five days of the service date. To learn more about these programs online, visit our patient navigator area in patient services.
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 (866) 266-3935 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: Do you take credit cards or offer payment plans?
A: Wilcox honors MasterCard, Visa, Discovery, JCB and American Express. Convenient payment plans can also be arranged.
Q: What options do I have to pay my bill (check, cash, credit card)?
A: Wilcox Health 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 at the Wilcox Medical Center Same Day Surgery registration window Monday to Friday, 8 a.m. to 2 p.m. Or at Kauai Medical Clinic Lihue Central Registration, located on the first floor Monday to Friday, 7:30 a.m. to 5 p.m.
- By Phone: Credit card payments can be made by calling Customer Service at (808) 245-1399.
- Online: Payments can be made online at mychart.hawaiipacifichealth.org with a MyChart account.
Q: Can I deduct excise taxes?
A: Wilcox is a nonprofit tax-exempt hospital. No excise taxes are added to our bills. Therefore, no excise tax credit may be claimed on your Hawaii state tax return for our services.
This is a license agreement (Agreement) that permits you to access and use the information contained in the Dataset, as described below. Hospital grants a non-exclusive, non-transferable, revocable right to access the Dataset according to the terms and conditions in this Agreement. The term Dataset means the machine-readable file and its content.
The Dataset includes certain standard hospital charges posted for the specific purpose of complying with the Hospital Price Transparency Rule at 45 C.F.R. §§ 180.10-50. The Hospital Price Transparency Rule does not require Hospital to include all charges and payment arrangements for hospital services; please refer to the rule for information about the scope of services subject to disclosure. The standard charges in the Dataset do not reflect all adjustments applied by each payer that affect the final reimbursement amount paid to Hospital, including certain contractual terms, billing procedures, or reimbursement rules affecting final payment. The Dataset includes information on discounted cash prices for hospital services and service packages; however, eligibility for these prices is subject to Wilcox Medical Center's policies. Please contact Customer Service at 1-866-266-3935 for more information about eligibility.
The information provided in the Dataset and elsewhere on this webpage is neither a quote nor a guarantee of the amount that any patient will in fact be charged or owe for the services and service packages described therein. The standard charges and information in the Dataset may change over time. The standard charges in this Dataset should not be used as an estimate of financial liability, which will depend on each patient’s unique benefit plan, clinical needs, utilization, and coverage.
Note also that the standard charges in the Dataset do not include all professional charges (including, but not limited to office visits, physician services, surgeon services, anesthesiologist services, emergency room physician services, radiologist services, pathologist services, consulting physician services, non-physician practitioner services, etc.) that you may incur during your hospital encounter. Additionally, there may be other charges associated with a particular service that are not reflected in the Dataset. For example, the standard charges in the Dataset for a surgical procedure may not include pre-procedure office visits, post-procedure office visits, or diagnostic testing.
The information provided on this webpage is not a guarantee of insurance coverage. Please consult with your insurance company, as applicable, to confirm individual payment responsibilities and if you have any questions regarding the scope of insurance coverage afforded by your insurance policy both for the service chosen and for any other associated services.
The standard charges in the Dataset are based on Hospital’s proprietary chargemaster rates, contractual agreements with payers, current policies, and other assumptions and inputs. Hospital makes no warranty, either express or implied, about the accuracy of the data for any individual consumer.
You acknowledge the limitations of the Dataset and accept responsibility for using the Dataset in an appropriate manner for your own purposes.I HAVE READ THE FOREGOING AND AGREE TO THE ABOVE TERMS AND CONDITIONS OF USE OF THE “STANDARD CHARGES FOR HOSPITAL SERVICES DATASET."