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Hospital invoice sample for Planning

thank you for choosing honor health your partner in care honor Health's goal is to keep your statements as simple as possible while giving you the information you need this video will highlight and help you understand the key parts of your hospital bill this is an example of one of the statements you may receive from honor health this statement is for a hospital visit you may receive separate bills from physicians who treated you who are contracted with honor health the front page of the statement provides information about your account where to send payments and how to contact us let's take a look at your statement in more detail at the top you'll find all the key information including the guarantor name the date the statement was generated and the total payment due the guarantor is the person responsible for paying the bill if you're a patient 18 years or older then you're considered your own guarantor if you're a patient younger than 18 then the guarantor will typically be your parent or legal guardian honor health wants to make your health care experience easier as a guarantor you'll receive one statement each month that will list all of your transactions for that month the total payment due shows the amount due on your account this includes other family members if you are their guarantor and whether each account is on a payment plan or not if you have insurance the insurance payments received will be deducted the total payment due is what you owe the middle section of your statement contains the details of honor health services provided to you for the month you'll find these summarized into categories for easy reading along with the dates of treatment if you have multiple accounts then the information will be itemized and grouped separately you can receive a more detailed breakdown of the charges by contacting patient financial services payments and adjustments are listed just below the service charges these may include insurance payments patient payments and other billing adjustments the balance remaining after these subtracted adjustments is shown on the far right your statement may continue on to the next page if you have multiple accounts or if you or a family member had an extended hospital stay each account listed on the bill will have a separate account number please use this as a reference when making your payment you may also notice different colors associated with the amounts on your bill if the total under patient responsibility is black then your bill is current if the total is highlighted in orange this is your second notice and the bill is overdue if the total is highlighted in red this is your third and final notice of your overdue bill if a payment is not made or if you don't set up a payment plan with us at this time the bill will be sent to collections the back page of the statement provides important contact information if you need to set up a payment plan or if you're seeking financial assistance if payment will create a financial burden if you'd like to make a payment by mail using a check money order or credit card fill in the information at the bottom of the statement detach it and mail it to honor health need to update your contact or insurance information the back of the pay stub has a section to make changes to your name address or insurance if you'd like to make a payment to multiple accounts you can use the bottom section to indicate which accounts you're paying along with the payment amounts for each to make a payment using your smartphone scan the QR code on the back of your statement if you'd like to pay over the phone call honor health during regular business hours to pay by debit card or checking account we can also assist you with payment plans and honor health.com you can pay your bill or set up recurring payments when paying online please use the p o-- box associated with your statement if you have any questions about your bill please contact honor health you'll find contact information in the lower middle portion of your statement we're available to go over any aspect with you in greater detail thank you for choosing honor health your partner in care