Patient Financial Services

For all bill payment questions, please call Eisenhower Patient Financial Services Monday - Friday, 8:30 a.m. - 4 p.m. at 800-453-6012.

Charity Care Policy

If you do not have insurance coverage, you may be eligible for charity care or other hospital discount. Any individual whose family income is at or below 400% of the Federal Poverty Level may be eligible for discounted services under the hospital's charity care policy. Individuals who have incurred out-of-pocket medical expenses in the prior 12 months exceeding 10% of their family income may also be eligible for coverage under the charity care policy.

MEDI-CAL AND OTHER GOVERNMENT FUNDED ASSISTANCE PROGRAMS
In addition, patients without insurance coverage may be eligible for government programs such as Medi-Cal, County Indigent and other government funded health care assistance programs.

UNINSURED PATIENTS NOT COVERED UNDER CHARITY CARE POLICY
Patients who do not meet the eligibility criteria for the charity care policy or are not eligible for other government programs may be eligible for discounted services based upon the hospital's uninsured discount policy.

For more information regarding the government programs and the hospital's charity and uninsured policies, please call Eisenhower Patient Financial Services at 800-453-6012.

You may obtain a charity application as well as government program applications at any admitting location or in the customer service lobby of the Patient Financial Services Department. All applications, as well as the policies for the charity and uninsured discounts are also available on our website. Please see the links at the right for more information.

Good Faith Estimate

You have the right to receive a “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 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 one (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 cms.gov/nosurprises or call Eisenhower Patient Financial Services at 800-453-6012.

Rights and Protections

Learn your Rights and Protections against surprise medical bills.

What is “balance billing” (sometimes called “surprise 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 isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t 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 can’t control who is involved in your care — like 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:

• Emergency services - If you have an emergency medical condition and get 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 can’t be balance billed for these emergency services. This includes services you may get after you’re 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 facility - When you get services from an in-network hospital, ambulatory surgical center or outpatient setting, laboratory, or radiology or imaging 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. You are not obligated to pay any cost-share amount until such time as your health plan notifies you of your in-network cost-share obligation for the service provided by the out-of-network provider. This applies to any service provided by an individual licensed to provide health care services. Moreover, individuals providing emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t 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.
• In the event you pay more than your in-network cost share amount when balance billing isn’t allowed, the provider shall refund any amounts over what you are responsible for paying within thirty (30) days after they receive payment from the insured.
• Your health plan generally must:
  • Cover emergency services without requiring you to get 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.
  • Notify you of the amount you owe at the time the health plan makes payment to the provider or facility for the services.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Centers for Medicare and Medicaid Services at 800-985-3059 OR the California Department of Managed Health Care at 888-466-2219, or by filing a complaint at HealthHelp.ca.gov.

Visit cms.gov/nosurprises for more information about your rights under federal law. Visit insurance.ca.gov for more information about your rights under California law.

Chargemaster

Effective Jan. 1, 2019 - federal regulations require all hospitals to post their Charge Description Master on their website. Please use the following link for a machine-readable copy.

• Download the Eisenhower Health Charge Master (size: 17 Mb; updated 07/17/24)

For more information visit the State of California Department of Health Care Access and Information (HCAI) website at Hospital Chargemasters - Datasets - California Health and Human Services Open Data Portal or call (916) 326-3854.

CMS Hospital Price Transparency File

Effective January 1, 2021 - each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways:

1. As a comprehensive machine-readable file with all items and services. Please use the following link for a machine-readable copy:
   • Download the machine-readable Eisenhower Health Standard Charges. (size: 248 Mb)
2. In a display of shoppable services in a consumer-friendly format. Please use the following link for a display of shoppable services:
   • Create Your Own Estimate

This information will make it easier for consumers to shop and compare prices across hospitals and estimate the cost of care before going to the hospital.

Physician Payments Sunshine Act

The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at openpaymentsdata.cms.gov. For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made to the public.

Políticas de Precios Justos en Atención Médica
POLÍTICA DE CUIDADOS DE CARIDAD

Si usted no está cubierto por seguro, podría ser elegible para cuidados de caridad u otro descuento de hospital. Cualquier persona cuyo ingreso familiar está al nivel o debajo de 350% del Nivel Federal de Pobreza, podría reunir las condiciones para los servicios descontados de acuerdo a las políticas de cuidados de caridad del hospital.

Las personas que han incurrido en gastos médicos de su propio bolsillo enlos 12 meses anteriores excediendo el 10% de sus ingresos familiares, también podrían reunir las condiciones bajo la política de cuidados de caridad.

MEDI-CAL Y OTROS PROGRAMAS DE ASISTENCIA FINANCIADOS POR EL GOBIERNO
Adicionalmente, los pacientes sin cobertura de seguro podrían cumplir con los requisitos para los programas de gobierno tales como MediCal, County Indigent (Indigentes del Condado) y otros programas de asistencia para atención médica que son financiados por el gobierno.

PACIENTES NO ASEGURADOS QUE NO ESTÁN CUBIERTOS BAJO LA POLÍTICA DE CUIDADOS DE CARIDAD
Los pacientes que no reúnen el criterio de los requisitos para la política de cuidados de caridad o no reúnen las condiciones para otros programas de gobierno, podrían cumplir los requisitos para los servicios descontados basándose en la política de descuento del hospital para los no-asegurados.

Para mayor información referente a los programas de gobierno, las políticas de caridad y no-asegurados del hospital, y las tarifas de descuento, favor de contactar a un consejero financiero en la extensión 760-773-1342, opción #6.

Usted puede obtener una solicitud de caridad como también solicitudes a programa gubernamental en cualquier lugar de admisión o en el lobby de servicio al cliente del Departamento de Servicios Financieros del Paciente. Todas las solicitudes, como también las políticas para caridad y descuentos para no-asegurados están disponibles en nuestra página web.

Este anuncio se despliega de acuerdo con el Código del Gobierno de California 15459.1. Por favor, vea a Departamento de Cumplimiento at 800-453-6012 antes de quitar este anuncio.

Patient Resources