- Patients of Wake Forest Baptist Health (WFBH) benefit from the expertly prepared doctors, scientists, nurses and other health care professionals educated and trained here.
- At WFBH, knowledge is generated, proven, shared and applied. Today’s research discoveries are quickly translated to improve the health care services we deliver to our patients.
- It is our commitment to provide health care to those in need and treat each patient with dignity and the utmost respect regardless of their ability to pay.
Pre-service Financial Clearance
- Many health care services are unplanned and hospital bills, physician bills and insurance claims can be confusing.
- WFBH is committed to helping our patients understand and manage the cost of services they receive before those services are delivered.
- To help our patients prepare for and manage the cost of care they receive, the WFBH registration team will perform an extensive set of pre-service review steps to assure that all information we have collected is accurate. Accurate information is critical to avoid billing issues and to assure that insurance benefits can be accessed to minimize your out-of-pocket expenses.
- If you believe you have an emergency medical condition and request services in one of our emergency departments, an appropriate medical screening exam will be provided regardless of your ability to pay.
- Before non-emergency services are delivered or after emergency conditions have been stabilized, our registration team will perform all of the following data validation checks:
- Validate and Protect Patient Identity – to protect your medical and financial information, we will use commercially available data sources to validate the accuracy of your name and address. To receive non-emergency services, we will ask you for a photo ID and will include a copy of your photo ID with your medical record.
- Verify Insurance Benefits – to minimize your expenses, we will collect your insurance information and will use our data systems to communicate with your insurance company to verify your eligibility and benefits. If you don’t provide insurance information, we will still check with major insurance companies and the North Carolina Medicaid program to see if you have eligible coverage.
- Verify Medical Necessity – not all services are covered by insurance policies, so to minimize your costs associated with services not covered by insurance we will verify the appropriateness of pre-service diagnosis and procedure codes so that you can make an informed decision about receiving the recommended services.
- Obtain Prior Authorizations – if the services you are to receive require prior authorization from an insurance company, we will attempt to secure that authorization from your insurance company. Each patient is responsible for making sure that his/her insurance benefits will cover the cost of services to be provided. If we are unable to obtain prior authorization from your insurance company, you are responsible for the cost of services delivered.
- Identify Open Bad Debt Accounts – if you have previously unpaid accounts that have not been enrolled in a payment plan, those balances must be paid in full or enrolled in our interest-free payment plan.
- Produce an Estimate of Service Costs – to help you make informed health care purchasing decisions, you may request an estimate of service costs and patient liabilities. Our registration team will use all of the validated data described in this section to estimate your out-of-pocket expenses based on your insurance benefits, your insurance company’s prior authorization requirements and any open prior balance accounts.
- Identify Available Programs - if you do not have insurance, our registration team will work with you to determine if you qualify for any third-party coverage programs and will provide a personalized list of health coverage options to you. To learn if you qualify for any private health insurance or publicly-sponsored programs, visit www.CoverageForAll.org.
- Provide Enrollment Assistance - if you qualify for one or more programs, our financial counseling team will assist you in applying for benefits under the program(s).
- Screen for Charity Care - if you do not qualify for a program, our registration team will access commercially available financial data about you to automatically screen for eligibility through our charitable mission. We will only access these data as part of our pre-service financial clearance process when you request medical services and a third-party payer source cannot be identified. Coverage of a patient’s health care expenses through our charitable mission is always the payer of last resort. If you qualify for any private health insurance or publicly-sponsored programs, you must enroll in the program to receive non-emergency services at WFBH.
- Provide COBRA Assistance - if you are eligible for COBRA coverage through a previous employer, WFBH may (solely at our discretion) be able to help pay the costs of enrolling in the private health insurance plan.
- The combination of these activities constitutes our pre-service financial clearance process. Our pre-service financial clearance process is designed to help our patient’s manage unexpected costs associated with health care services by untangling the web of confusion created by complex billing and insurance coverage rules.
- WFBH provides interest-free payment plans to help patients manage balances within their budgets.
- Wake Forest Baptist Health’s care delivery relationship is between you (the patient), your doctor and our hospitals. WFBH clinicians will develop treatment plans in consultation with our patients. The patient’s acceptance of the treatment plan is acknowledged through signature of the Consent to Treat. The costs associated with the services received by the patient are the responsibility of the patient or the patient’s guarantor.
- WFBH will maintain discount contracts with certain government and private insurance payers. WFBH provides third-party payers with discounts against list prices in exchange for timely and efficient bill payment, and in most cases we maintain excellent relationships with top governmental and private insurance companies.
- Regrettably, the recent trend in health insurance benefits has been to cover less of the cost of health care rather than more. As health insurance policies cover less of the cost of care, patients become responsible for a greater portion of their hospital and physician expenses.
- WFBH will bill for services according to guidelines established by the American Medical Association and/or Centers for Medicare and Medicaid Services.
- When a payer denies payment for services delivered, WFBH will seek payment directly from the patient, unless otherwise prohibited by state or federal regulations.
- If a patient disagrees with how a service was billed or how insurance benefits were applied, our business office patient accounts team will gladly assist with billing review, appeal preparation and escalation to appropriate regulatory agencies.
- As part of our pre-service financial clearance process, our financial counseling team will contact you or a family member for deductible and out-of-pocket expenses due.
- Minimum deposits are required prior to delivery of non-emergency services with complete payment arrangements made prior to discharge.
- Financial assistance is available for qualified parties. Learn more about financial assistance.
Single Patient Statement
- Effective April 16, 2012, patients of North Carolina Baptist Hospital and Wake Forest University Physicians will receive a single statement for both physician and hospital charges.
- In the coming months, we will expand the integrated billing process to include Lexington Memorial Hospital and Davie County Hospital.
- Our new combined patient statement is intended to make the billing process more understandable and manageable for our patients by reporting hospital and physician charges on a single bill.
- Charges for each individual of a household will be clearly identifiable and listed individually on a single statement for the guarantor (person responsible for the bill).
- When a patient has provided insurance information, Wake Forest Baptist Health will only bill our patients after insurance has processed your claim.
- Two patient statements will be generated 28 days apart. Each statement will provide the opportunity to pay the balance in full or spread the balance out through interest-free monthly payments.
- You must communicate with us to set-up a balance on a payment plan. Unpaid balances older than 120 days from initial billing that have not been enrolled in a payment plan will be sent to a collection agency.
- If at anytime you need more time to pay your balance, you must call us to make arrangements and we will gladly assist you. If you call us and make arrangements, we will not send your account to collections.
- Customer Care Center can answer questions about your hospital bill and help you interpret financial policies and billing procedures at the hospital. Patient Accounts can be reached by calling: 336-716-3988 or 877-938-7497, Monday through Friday from 8 am to 5 pm.
- WFBH has an online option to pay your bill.
- We accept major credit cards, debit cards and flex spending cards and electronic checks.
- In order to pay your bill on line, please have your most recent statement and select the appropriate billing organization:
- You will be directed though a set of easy to follow instructions and will be given an opportunity to print a receipt for your records.
- If you do not want to make an online payment, you may call Customer Care:
- 877-938-7497 or
- Follow the menu options and instructions and enter the information when prompted.
If you need to talk to a Wake Forest University Physicians Customer Service Representative, please call 336-716-3988 (local) or 877-938-7497 (toll-free).
Si Usted nesecita hablarle a un Representante de Servicio al Cliente del Wake Forest University Physicians, por favor llamar al 336-716-3988 (local) o al 877-938-7497 (gratis).