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Understanding Hospital Charges

Medical billing can be confusing. From health insurance to hospital charges and physician fees, there are a number of factors that impact what patients pay for services and procedures.

It Starts with Health Insurance

If you have health insurance, the hospital billing process begins when Baton Rouge Rehabilitation Hospital (BRRH) receives your insurance policy information, including policy number and the name and address of your insurance company. Once we receive this information, BRRH files a claim with your insurance company on your behalf, notifying your health insurance company of your upcoming healthcare visit or procedure.

  • Insurance
    Your insurance coverage has a lot to do with the final amount that you will pay. BRRH has contracts with insurance companies that determine the amount that will be paid for certain procedures, often making out-of-pocket payments lower than they would be without the contract. Any insurance adjustments that you see on the Explanation of Benefits (EOB) change the final amount that is billed from the original hospital charges (hospital charges and average diagnosis-related group (DRG) pricing) to the price that your insurance company and the hospital have agreed upon. The best way to understand all the factors affecting what you will have to pay is to contact your insurance company directly.
  • Medicare
    Not everyone with Medicare has the same type of coverage. And while Medicare will pay for many of your healthcare expenses, there may be some that aren't covered. The best way to be sure of what your Medicare plan covers is to call 1-800-MEDICARE, or visit the website at
  • Medicaid
    Contact your local Medicaid office at 1-888-544-7996, or visit the Louisiana Department of Health to determine all the factors affecting your financial responsibility. In general, Medicaid recipients are not responsible for any portion of their hospital bill.
  • No Insurance
    Patients without insurance coverage are encourage to contact the hospital at 225-927-0567 for an estimate of how much your treatment will cost.

Explanation of Benefits (EOB)

You should receive an Explanation of Benefits, or EOB, from your insurance company within four to six weeks after BRRH files your claim. This will highlight the services that BRRH is billing for, the amount paid, the amount adjusted, and the healthcare provider that treated you. The EOB will also provide information on your balance, which could include co-pays, deductibles, or co-insurance.

Your Bill

Your health insurance coverage has a lot do with the final amount that you owe the hospital. You will not receive a bill from BRRH until your health insurance company has paid their portion of your bill.

Questions about your bill?
(225) 819-1000

Insurance FAQs

Keep in mind that every insurance plan is different. Some plans require co-pays, some include deductibles, and some require both (or neither!). The answers below are intended to provide basic, generalized information about how many insurance plans work, but they are not universal.

What is a co-pay?
An upfront payment for your hospital visit required by some insurance plans. Examples of copays are set amounts paid at ER visits or doctor's office visits.

What is an Explanation of Benefits (EOB)?
A document from your insurance company that outlines what they are paying on your behalf.

What is a deductible?
How much of your costs your insurance plan expects you to pay in a year before your plan starts splitting the costs.

What counts towards my deductible?
It depends on your insurance plan. Usually most out of pocket medical expenses such as copays, payments on medical bills, and prescriptions count towards your deductible.

What is co-insurance?
The portion of care expenses you are responsible for after you have met your deductible. This amount is a percentage of the amount that was billed to your insurance company based on the contracted fee schedule.

What is an out-of pocket maximum?
This is the most you will pay each year for medical expenses per your agreement with your insurance company.

Hospital Chargemaster and DRG

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