Pricing Estimates for Insured Patients

Obtaining an Estimate
In order to provide insured patients with the most accurate estimate based on your specific plan coverage and prospective services, please contact our Service Center at (936) 568-8497 and one of our Financial Representatives will be happy to assist you.

Prior To Your Call
Prior to your call, it is important that you contact your insurance company to ensure that the services required are "covered services." In the event that they are not a covered service under your plan, please refer back to our Uninsured information.

You will also need to contact your physician's office to get the specific diagnosis or procedure description.

When you call our Service Center, please have the following information available, so that we can provide you with the most accurate estimate possible:

  • Description of Services Needed - we will need to know as much information as possible about the specific services as described by your physician.
  • Type of Services Needed - we need to know if you will be admitted to the hospital as an inpatient overnight, or if you are expected to be treated on an outpatient basis.
  • Physician/Specialist Name - example, if you are having surgery, we will want to know the surgeon's name.
  • Your Insurance Card - please have your card available so that if needed, we can get the following information from you: name of insurance company, type of policy (e.g. HMO, PPO, POS, Indemnity), policy holder's name, group name and number, policy number, insurance company phone number.
  • Policyholder's Personal Information - it is possible that the insurance company will want us to verify the Social Security Number and date of birth of the person who is named as the primary insurance policy holder.

During your call, we will attempt to verify your specific insurance benefits to provide the most accurate representation of your estimated financial obligation based on your specific coverage.

Your Hospital Bill
This is how our billing process usually works. A claim will be sent to your insurance company shortly after your services are complete.

After your insurance company receives the claim, the insurance company may contact you for additional information. Please respond to your insurance company's questions as quickly as possible so their payment to us is not delayed.

It usually takes 30 - 45 days for your insurance company to pay your claim. After your insurance company pays us, we will provide you with information about any amount you may still owe.

Please keep in mind that your policy is a binder between you and your insurance company. If you did not follow your insurance plan's terms, they may not pay for all or part of your care.

Types of Statements
Itemized or Summary Bills

Shortly after you receive any type of hospital service, you will be sent a Summary Bill. This bill is sent for two reasons.

1. To inform you of the total amount of hospital charges accumulated during your most recent visit.
2. To notify you that your insurance company has been billed for these charges.

This bill, and all other statements sent by the hospital, list only your hospital charges. Charges for physician services (except ER physicians) are not billed by the hospital.

Statement of Account
The second type of bill you will receive from our office is called a statement of account. This statement will show you:

1. Your beginning balance.
2. Any payments, since your last statement, that have been made on your account by you or your insurance company.
3. Your current or remaining balance.

Because of our billing cycle and the time it takes to file insurance claims, you may receive a statement of account before your insurance company makes any payment on your claim. The final remaining balance, the amount of money that you owe the hospital, is due within 30 days after your insurance company pays for covered charges.

Because our goal is to provide consumers with helpful information, we feel it is our responsibility to explain some of the complications involved in determining a patient's bill. Providing you with an estimate of your potential costs is an imperfect process and although we would like to guarantee our pricing estimates, it would be inappropriate to do so. You see, when you have services at our facility, your costs may be less or more than what we estimated because of a number of reasons. All estimates are based on information provided to us by a prospective patient and we compare that information to our hospital's historical pricing for comparable services. We cannot predict or estimate for changes in treatment decisions, unforeseen complications, and additional tests or procedures ordered by a physician, among other things.

If you have any questions and wish to speak to a representative, please call us at (936) 564-4611.

*Nacogdoches Memorial Hospital (NMH) makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and NMH cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill for services rendered at NMH may differ substantially from the information provided by this website, and NMH shall not be liable for any inaccuracies.

The Women's and Children's Center
One of the most family-centered, comfortable labor and delivery programs in East Texas
© Nacogdoches Memorial Health 2021