Billing and Insurance

Understanding Your Statement

Before billing you, UCSF Health will submit a claim to your health insurance provider, including Medicare and Medi-Cal if applicable, and any secondary insurance. If you owe a balance that was not covered by your insurance, or if you are a self-pay patient, you will receive a statement by mail.

UCSF Health provides patients with a consolidated statement (per guarantor) that includes fees for both hospital and professional services. Hospital services include costs for room and board, ancillary services such as diagnostic tests (for example, X-rays, EKGs and laboratory tests) and medications. Professional services include care from the physicians who treated you during an outpatient visit or hospital stay, as well as physicians who read and interpreted your test results (such as a radiologist).

If you have any questions about your statement, please call Patient Financial Services at (866) 433-4035. A sample statement is available here to help you understand your bill.

Payment Options

Payment is due within 30 days of billing. We accept personal checks and major credit cards (Visa, MasterCard, American Express, and Discover).

You may use any of the following options to pay your balance:

• Online, via MyChart
• Mail: Complete and return the payment coupon attached to your statement
• Phone: Call (866) 433-4035 (automated payment system available 24/7)

Health Insurance

If you have health insurance, our billing office will first bill your insurance carrier. If your insurance plan does not cover a service or procedure or does not cover the entire cost, you will be responsible for the non-covered fees.

If you have insurance coverage and wish to update your insurance information for billing, please contact Patient Financial Services immediately at (866) 433-4035. Most insurance companies have timely filing requirements.

Medicare

If you are covered by Medicare, we will submit your claims to Medicare on your behalf. After Medicare makes its payment, we will bill your supplemental or secondary insurance carrier for the remaining balance, as determined by Medicare. If you don't have supplemental or secondary insurance, you will be responsible for the remaining balance. Please refer to your EOMB (Explanation of Medicare Benefits) or your EOB (Explanation of Benefits) from your supplemental or secondary insurance for additional information.

Medi-Cal

Medi-Cal is California's Medicaid program, a medical assistance program for low-income residents funded by the state and federal government. If you are covered under this program, please provide an eligibility card or other proof of eligibility for your month of service. Medi-Cal eligibility is determined on a month-to-month basis.

Self-Pay and Financial Assistance

If you don't have health insurance or if you are seeking care that is not covered by your insurance plan, you are considered a self-pay patient. All self-pay patients at UCSF are eligible for a discount. For additional information about our discount policy, please contact the Financial Counseling office at (415) 353-1966. To request an estimate for the out-of-pocket cost for an upcoming service, please contact Financial Counseling's Patient Estimate Program at (844) 678-6831. Financial counselors are available to discuss your options and offer guidance in the financial planning of your medical care or services.

Self-pay patients may also qualify for financial assistance through eligibility for government programs or our charity care assistance. If you wish to seek financial assistance, please complete a financial assistance application. (The application instructions and form are available here.) Those with a family income at or below 400 percent of federal poverty guidelines generally qualify for 100 percent assistance.

Elective procedures require a deposit prior to service, unless the patient is eligible for financial assistance. If you need to make a deposit or arrange a payment before an elective procedure, please call Financial Counseling at (415) 353-1966. If you wish to make payment arrangements, or apply for financial assistance for an outstanding statement balance, please call Patient Financial Services at (866) 433-4035.