Billing and Insurance

Billing and Insurance Frequently Asked Questions

Billing FAQs

  1. Am I responsible for my hospital bill?
  2. Can I receive an itemized bill?
  3. Are physicians' fees included in my hospital bill?
  4. What charges are included in your inpatient room rate?
  5. Do I need to pre-register for my appointment?
  6. Do I need to pre-register if I'm pregnant?
  7. How do I submit a claim to my insurance company?
  8. Do you accept Medicare?
  9. What do I do if I am unable to pay my hospital bill?
  10. Do you offer payment plans?
  11. Do you accept credit cards?
  12. Can I pay my hospital bill online?
  13. What is my co-pay for outpatient services provided at the hospital?
  14. How can I request an online bill pay refund?

Insurance FAQs

  1. I don't have insurance. Can I still receive hospital services?
  2. What if my insurance doesn't cover the entire cost of my care?
  3. What insurances do you accept?
  4. Do I need pre-certification for hospital services?
  5. I don't have insurance. How can I get coverage for myself or my family?

Billing FAQs

Am I responsible for my hospital bill?
Yes. Your account is your responsibility and you are responsible for payment of any services provided. As with any bill, we expect to receive payment in a timely manner.

We will first bill Medicare, Medicaid or your insurance for services provided. Any portion of your hospital bill that is not covered by insurance is your responsibility.

You will be required to sign a Consent for Treatment and Responsibility for Payment form regardless of third-party insurance coverage.

Please note that delinquent accounts are referred to outside collection agencies when payment in full has not been received or appropriate payment plans have not been arranged. These accounts are assessed interest.

Can I receive an itemized bill?
Yes. As a cost-savings measure we do not routinely send out copies of itemized patient bills. However, if you would like a copy of your itemized bill, please call Patient Business Services at 262-928-2311.

Are physicians' fees included in my hospital bill?
No. Your hospital bill does not include charges from any physicians who provide services directly to you or on your behalf. Each physician involved in your care will bill you separately for services provided. The amount due to your physician(s) is in addition to your hospital bill. Questions about physicians' fees should be directed to their billing offices.

All of the hospital-based physicians who practice at WMH and OMH are independent practitioners and may not participate in all of the same health insurance plans as the Hospitals. Although it is rare, on occasion you may be treated by a physician who is not considered in-network with your health insurance plan. Should this occur and result in problems with payment, we encourage you to contact your insurance company to determine if your plan contains a special provision for instances when there was not a choice of which physicians became involved in your care. If you have any questions, please contact Patient Accounts at 262-928-2311.

What charges are included in your inpatient room rate?
If you are an inpatient, your hospital room rate includes routine nursing care, meals, television and telephone services. You are charged for the day you enter the hospital but not for the day you leave. Check out time is 11 a.m.

Do I need to pre-register for my appointment?
Yes. To avoid delays in treatment for scheduled hospital appointments, we request that you pre-register so that we may obtain all necessary information to provide your care. This includes insurance information, personal data, emergency contacts, religious preferences and more. 

For your convenience, Waukesha Memorial Hospital's Admitting office is open 24 hours a day, seven days a week. You can pre-register for your scheduled appointments online (we apologize that online pre-registration is temporarily unavailable) or by calling 262-928-4045.

If you register online, please register at least 24 hours prior to your scheduled appointment to ensure your information is recorded in our system. Please have your insurance cards handy when you call or register online.

Do I need to pre-register if I'm pregnant?
Yes. If you are expecting a baby and plan to deliver at Waukesha Memorial, pre-registration is requested. Pre-registration forms are available in your physician's office.

If your insurance changes during your pregnancy or course of treatment, it's very important that you provide this information to your caregivers and our Patient Business Services office as soon as possible. Changes to your insurance may affect your benefits and new authorizations for treatment may be required.

How do I submit a claim to my insurance company?
If you have insurance or HMO/PPO coverage, our Patient Business Services office will bill your insurance on your behalf if complete billing information was provided at the time of admission/service. You will be notified by letter if you insurance carrier or HMO/PPO does not pay the bill promptly or if there is a balance remaining after the insurance or HMO/PPO payment.

If you have questions regarding your insurance company's payment, you should contact your insurance company directly to check on the status of your claim.

Do you accept Medicare?
Yes. Waukesha Memorial Hospital is a participating provider for Medicare and accepts assignment of covered benefits. After Medicare pays its portion of the charges, we will bill your supplemental insurance based on the information you provided during the registration process. You will receive a letter from us notifying you of your responsibility if there are any balances remaining after Medicare and your supplemental insurance payments.

What do I do if I am unable to pay my hospital bill?
Patients who are unable to pay for hospital services are welcome to apply for Waukesha Memorial Hospital's Community Care program. Applications are available in the Patient Business Services office or by calling (262) 928-2311. Eligibility is based on residency, household income, family size and the financial resources of your household.

To be eligible for assistance, you must be a legal resident of ProHealth Care's primary service area. Federal poverty income guidelines are used as the basis for eligibility. The Community Care program involves only select hospital charges. Some hospital services are not included in this program.

Please note that physician's fees are not included in the hospital's Community Care program. If you need assistance in paying physician's bills, please contact your physician's office directly.

Waukesha Memorial Hospital also offers payment plans. If you would like to arrange a payment plan, please contact Patient Business Services at 262-928-2311.

Please note that delinquent accounts are referred to outside collection agencies when payment in full has not been received or appropriate payment plans have not been arranged. These accounts are assessed interest.

Do you offer payment plans?
Yes. To arrange a payment plan or obtain more information, please contact Patient Business Services at 262-928-2311.

Do you accept credit cards?
Yes. Waukesha Memorial Hospital accepts MasterCard, Visa, American Express and Discover. Please call (262) 928-2311 to make a payment. You may also pay your hospital bill online  using MasterCard or Visa.

Can I pay my hospital bill online?
Yes. Waukesha Memorial Hospital offers online bill payment. You will need your hospital account number and one of the following credit cards to make a payment online: MasterCard or Visa. Online payments are secure.  Visit our online bill payment page to make a payment.

What is my co-pay for outpatient services provided at the hospital?

If you are being seen in an outpatient department of the Waukesha Memorial or Oconomowoc Memorial Hospital, please be aware that this is not a doctor's office. This visit will be billed as a hospital outpatient service and your hospital benefit levels will apply. You might receive more than one bill after your care.

  • One bill will be for hospital charges
  • You might also receive a bill for the professional services of any doctors you see today or any doctors who interpret results of your diagnostic tests.

If you are a Medicare patient, listed below is an estimate of your coinsurance amount only. Your actual out-of-pocket expense may be higher or lower depending on your deductible, and any other insurance that you may have.  

Angiography ($175 - $355)

Biopsy ($32 - $300)

CT Scans ($40 - $150)

Carpal tunnel ($240 - $260)

Diagnostic Radiology ($30 - $110)

Cataract Procedures  ($110 - $510)

Mammograms ($6- $16)

Chemotherapy ($5 - $40) drugs not included

MRI ($140 - $205)

Colonoscopy Procedures ($200 - $320)

Myelography ($130)

Debridement ($10 - $20)

Myocardial Scans ($150)

Endoscopy ($145 - $240)

Nuclear Medicine ($45 - $120)

ENT Procedures ($37 - $623)

Ultrasound ($25 - $70)

Eye Procedures ($46 - $812)

Venogram ($115)

Foot Procedures ($355 - $500)

GI procedures ($150 - $250)

Echocardiogram ($100 - $110)

Hemorrhoid Surgery ($225 - $245)

EMG ($15.00-$20.00)

Injections ($5-$30)

Stress Tests ($210.00)

Kidney Stone ($1025 - $1225)

Vascular Studies ($20-$35)

Nail Procedures ($10 - $80)

Nerve Injections ($44 - $375)

Cystoscopy ($78 - $85)

Sigmoidoscopy ($70 - $90)

Interstim Programming ($20 -$70)

Trigger Finger-tendon sheath ($270 - $420)

Percutaneous Tibial Nerve Stim ($41 - $50)

Wound Care ($31 - $75)

Urodynamic Study ($75- $150)

Cardiac Rehab ($15.00 - $25.00)

Clinic Visits ($9 - $20)

Physical Therapy ($5.00 - $15.00)

If you are a non-Medicare patient, we may ask you to pay the co-payment amount indicated on your insurance card. This amount will be applied toward the balance due from you (if applicable) after your insurance pays. Additional amounts you will owe, which could include a deductible, co-insurance and non-covered services, will depend upon your insurance plan. 

If you have any questions about your bill or your explanation of benefits, please call Patient Accounts at 262-928-2311.

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Online Bill Pay Refund Policy

All transactions processed through ProHealth Care's Online Bill Payment system are eligible for a refund. To cancel an online payment that has already been submitted, please contact ProHealth Care's Patient Accounts Department at 262-928-2311.

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Insurance FAQs

  1. I don't have insurance. Can I still receive hospital services?
    Yes. Waukesha Memorial Hospital does not deny anyone services.
  2. What if my insurance doesn't cover the entire cost of my care?
    If any portion of your account is not covered by insurance, you are required to pay the balance. Please contact the Patient Business Services office at (262) 928-2311, Monday-Friday, 8 a.m.-4 p.m., for more information or to make financial arrangements.

    Please note that delinquent accounts are referred to outside collection agencies when payment in full has not been received or appropriate payment plans have not been arranged. These accounts are assessed interest.
  3. What insurances do you accept?
    Waukesha Memorial Hospital participates in most managed care plans offered in the Waukesha/Milwaukee area. If you have a question about whether or not we participate in your insurance plan, please check directly with your provider.
  4. Do I need pre-certification for hospital services?
    Most insurance plans require you to obtain pre-certification; however, it is up to you to find out if your insurance or HMO/PPO requires pre-certification for any care provided at the hospital. If pre-certification is required and you or your physician do not take steps to ensure that this authorization is obtained, reduced benefits or the denial of your entire claim by your insurance company is possible.

    However, if you are pre-scheduled for a test or procedure and do not have insurance, you may be asked to pay all or a portion of the expected charges prior to the procedure with the balance of the charges due within 60 days after the procedure. Emergency care is always provided regardless of ability to pay.

    Uninsured Patients
    Patients without insurance may be eligible for discounts.  Prompt payment discounts of up to 20 percent are offered to patients who make timely payments for services they receive. To learn more about this program, please call Patient Business Services at (262) 928-2311.

    Please note that delinquent accounts are referred to outside collection agencies when payment in full has not been received or appropriate payment plans have not been arranged. These accounts are assessed interest.
  5. I don't have insurance. How can I get coverage for myself or my family?
    The National Association of Health Underwriters offers a user-friendly Web site that provides information about private health insurance coverage, as well as the many public and private programs available to Americans to help them obtain the medical care they need. You can even search for information by state.

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