At Pender Community Hospital & Medical Clinics, we understand dealing with the burden of medical bills is the last thing patients—and their family members or guardians—want to worry about during the recovery process. For that reason, our organization has procedures, policies, and programs in place to ensure the bill paying process is as simple and stress-free as possible.
Hospital & Clinic Billing & Insurance Information
The billing office will automatically file your claims with Medicare, Nebraska Medicaid, and most commercial insurances. We ask that you present your current insurance card(s) and information at the time of registration for accurate billing. You will receive a statement from Pender Community Hospital & Medical Clinics after your insurance(s) paid their portion of the claim. Depending on the type(s) of services rendered, you may receive a separate statement from specialty physicians, radiology, and/or pathology. Please keep in mind that you are responsible for your deductible, co-insurance and any portion of your bill not covered by your insurance policy.
If you have questions about your statement or would like an itemized bill of your account, please call 402-385-3083, option 1 or via email at firstname.lastname@example.org and ask to speak with one of our helpful billing clerks.
Pender Community Hospital & Medical Clinics provides financial assistance to qualifying patients with limited financial means who have exhausted all other sources of payment options.
A financial counselor is available at our facility to assist you with payment of your bill or, if needed, to set up a payment plan. Our financial counselor will make every reasonable effort to help you make financial arrangements for bill payment in accordance with our hospital policy. If you are in need of assistance, please complete the below form and return it to our financial counselor listed at the address below. Our financial counselor can also be reached by phone at 402-385-4024 or by coming to the office located in our hospital facility.
Pender Community Hospital
PO Box 100
Pender, NE 68047
Policies & Forms
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, like a copayment, coinsurance, or deductible. You may have additional 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” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the diference between what your plan pays 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 plan’s deductible or 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. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
You’re protected from balance billing for:
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get afer you’re in stable condition, unless you give writen 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 get 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 can 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 can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give writen 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 out-of-network care. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
- You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
- Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (also known as “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 benefts.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.