Billing & Insurance Frequently Asked Questions – English
Hospital in El Dorado County
On this page you can find answers to some common questions about billing
and insurance procedures at Marshall Medical Center. If you cannot find
what you’re looking for here, feel free to call our business offices
at (530) 626-2618 or
submit your question online.
Will my Insurance pay for may care at Marshall Medical Center?
The following questions may help guide you in better understanding your
insurance and how it works:
Is this care a covered service under my insurance policy?
- Read your policy booklet or call the customer service number on your insurance
card. It is important that when you receive a service, the facility, the
physician, and the service are all part of your insurance benefits.
Have I met my deductible?
- Call the customer service number on your insurance card. They can help
you estimate what your financial responsibility will be for your medical services.
Is pre-authorization required from my insurance company?
- Your physician may need to get pre-authorization for the care you receive
at Marshall Medical Center. Check your policy booklet or call the customer
service number on your insurance card. If you think pre-authorization
is needed, find out if your doctor has obtained authorization before you
come to Marshall Medical Center. If pre-authorization is needed and your
doctor does not get it, you may have to pay for the care.
Is this an emergency?
- If you come to our emergency room, you are entitled, by law, to receive
an emergency medical screening exam, regardless of your insurance or your
ability to pay. Your insurance must pay for the exam, as long as a prudent
person would have believed an emergency existed.
Is Marshall Medical Center a covered provider under my insurance?
- Check your policy booklet or list of providers given to you by your insurance
company OR call the customer service number on your insurance card to
see if care is covered at Marshall Medical Center. See below for more
information about the relationship between Marshall Medical Center and
Will Marshall Medical Center bill my insurance?
- Yes. You may be asked to give us your insurance card or other information
about your insurance. Even if Marshall Medical Center bills your insurance,
you remain responsible for payment for all care you receive. This may
include care denied or not covered by your insurance, as well as your
deductible and co-payment amounts.
Is Marshall Medical Center contracted with my insurance?
- We cannot answer this question because we do not have information about
the plan you have chosen with your insurance company. Insurance companies
sell many types of plans. Marshall Medical Center may be contracted with
your insurance company, but not for all of the plans they offer. For example,
services at Marshall Medical Center may be covered for someone with a
PPO policy from Acme Insurance, but not for someone with an HMO policy
from Acme Insurance.
- Insurance plans may say that some services must be provided at places other
than Marshall Medical Center, even if a contract with your insurance company
is in place with Marshall Medical Center. Ultimately, understanding your
insurance is your responsibility. Please call the customer service number
on your card to avoid any financial penalties for not following your insurance
- In addition, certain insurance companies may use other networks of other
insurance companies, and not tell Marshall Medical Center. Therefore,
services at Marshall Medical Center may be covered through one of these
networks, even though your insurance does not have a direct contract.
Can I still get my care at Marshall Medical Center, even if my insurance
may not cover the services?
- We welcome the opportunity to provide you with excellent healthcare, regardless
of your insurance. You should be aware that you may have to pay for the
services you receive. However, you can choose to get your health care
where you feel comfortable.
What about physician services?
- The care you receive at Marshall Medical Center includes Facility Services
provided by Marshall Medical Center. Your care may require Professional
Services provided by physicians. These physicians are separate from Marshall
Medical Center and will bill you directly.
- Verify that both Marshall Medical Center and the doctor are contracted
with your insurance. It is possible that your insurance company is contracted
with Marshall Medical Center, but not the physician providing your care
and vice versa.
Some of the physician services provided within Marshall Medical Center include:
- Diagnosing, evaluating and managing your health care needs, including emergency
- Ordering and reviewing your diagnostic tests
- Reading and diagnosing your x-ray, CAT scan or MRI
- Reviewing and diagnosing your laboratory and pathology samples
- Supervising the administration of anesthesia
- Performing surgical and specialized procedures
- Some of the physician groups which provide care at Marshall Medical Center
are the Marshall Center for Primary Care, Emergency Physicians Medical
Group, El Dorado Anesthesia Group, Placerville Radiology Medical Group,
and El Dorado Pathology Medical Group.