Insurance and Payment
Billing & Insurance
Insurance Policies
Choptank Health participates with Medicare, Medicaid, and many local and national insurance plans. We want to make sure you understand how your insurance works before your visit. It is important to know that there are two different ways a provider can work with an insurance plan. Understanding the difference can help you know what to expect when it comes to your bill:
Participating with an Insurance Plan (In-Network):
This means Choptank Health has a formal contract with your insurance company. Because of this contract, we have agreed to accept a set rate for our services. Your insurance company will pay their portion of that agreed-upon rate, and you are only responsible for your share, such as your copay, co-insurance, or deductible. You will not be billed for any amount above what the contract allows.
Accepting an Insurance Plan (Out-of-Network):
This means Choptank Health does not have a contract with your insurance company, but we will still bill your plan on your behalf as a courtesy. Your insurance may pay a portion of the bill. However, whatever amount your insurance does not pay, called the remaining balance; or balance billing, becomes your responsibility to pay.
Before your appointment, we recommend you check with your insurance company to confirm whether Choptank Health is in-network (participating) or out-of-network for your plan. You can do this by calling the member services number on the back of your insurance card, or by looking at your plans provider directory online.
When you provide us with your complete and correct insurance information, we will submit your medical claims directly to your insurance company on your behalf. This means you generally do not need to handle the paperwork yourself.
Depending on your insurance plan, you may still owe some money out of pocket. Here is what those terms mean:
Co-payment (Copay):
A set dollar amount you pay each time you have a visit. For example, your plan might require a $20 copay for a primary care visit.
Co-insurance:
After your deductible is met, you and your insurance company share the cost. For example, your plan might pay 80% and you pay 20% of the remaining balance.
Deductible:
The amount you must pay out of pocket each year before your insurance starts covering most costs. For example, if your deductible is $500, you pay the first $500 of covered services each year.
You are responsible for paying any of these amounts that apply to your account.
Copays
If your insurance plan requires a copay, please be ready to pay it at the time of your visit. Copays are required by your insurance company and cannot be waived or billed later. We accept cash, check, and credit or debit cards.
If you are unsure whether your plan has a copay, please call the member services number on your insurance card before your appointment.
Prior Authorization (Pre-Approval)
Some insurance plans require you to get approval before receiving certain services. This is called a prior authorization, or referral. It is your responsibility to make sure the required referral, or prior authorization, is in place before your appointment. If your plan requires it and it is not on file, your insurance may not pay for your visit, and you could owe the full cost.
To find out if your plan requires a referral or prior authorization, call the member services number on your insurance card.
Payment
If you do not have health insurance, payment for services is due at the time of your appointment. We accept cash, personal checks, and credit or debit cards.
If your insurance coverage has ended, or if the insurance information you provided turns out to be incorrect, you will be responsible for the full cost of the services we provided. We will make every effort to work with you, but if we are unable to collect payment, we may need to send your account to a collection agency. If that happens, you may also be responsible for the collection fees added to your balance.
You can pay your bill online through the Patient Portal. You will need the statement code found on your billing statement. Click the link below to access the portal:
Choptank Community Health System (CCHS)
Patient Financial Assistance Program
Choptank Community Health System (CCHS) understands that paying for healthcare can be hard. That is why we offer a Patient Financial Assistance Program with a sliding fee scale. This means the amount you pay is based on your family size and income, so you only pay what you can reasonably afford.
This program can help cover costs for medical, dental, and behavioral health services.
How to Apply for Financial Assistance:
1. Download the Sliding Fee Application. To apply for the CCHS Patient Financial Assistance Program, click the link to download the Sliding Fee Application, then follow the directions. Sliding Fee Application in Spanish. Sliding Fee Application in Haitian Creole.
2. Gather your supporting documents. You will need to include documents such as recent bank statements, W-2 forms, or pay stubs to show your income and family size. These documents are required for a complete application.
3. Complete and return the application within 30 days. Submit your completed application and all supporting documents to your CCHS office. Incomplete applications may be denied.
4. Wait for a decision. We will review your application and let you know our decision within 5 business days of receiving everything.
If you need help filling out the application or have questions about the process, please ask to speak with the Community Support Specialist at your CCHS office. We are here to help.
Have Questions?
We know that billing and insurance can be confusing. Please do not hesitate to talk with our staff if you have any questions about your services, your bill, or your coverage. Our goal is to work with you to prevent financial problems and to keep your account in good standing.