Frequently Asked Questions
Find answers to common questions about insurance, billing, payments and financial assistance.
Understanding Your Insurance Responsibility
Why do I have a bill if I have insurance?
Health insurance helps pay for healthcare costs, but it usually does not cover 100% of the cost. You may still be responsible for deductibles, copays, coinsurance or other amounts assigned by your insurance company.
What is a deductible?
The amount you must pay for covered services before insurance begins paying according to your plan.
What is a copay?
A fixed amount you pay for a covered service.
What is coinsurance?
The percentage of covered expenses you pay after meeting your deductible.
What is an out-of-pocket maximum?
The most you should pay for covered services during a plan year.
Why did my payment not apply to my deductible?
Not every payment counts toward deductible or out-of-pocket maximum amounts. This depends on your plan.
Why do I still owe money after insurance paid?
Insurance payments may leave deductible, copay or coinsurance amounts as your responsibility.
Understanding Insurance Claims
What is an Explanation of Benefits (EOB)?
A statement showing how your insurance processed a claim. It is not a bill.
Why does my EOB show a different amount than my bill?
The EOB explains claim processing while the bill reflects your current balance.
Why was my claim denied?
Possible reasons include non-covered services, authorization issues, incorrect information or out-of-network care.
Who do I contact if I disagree with my insurance decision?
Contact your insurance company and ask about appeal options.
What if my insurance information is incorrect?
Provide updated information to your health care provider promptly.
How are benefits verified?
Benefits are often verified electronically through Real Time Eligibility (RTE) systems or directly through the payer.
Medicare & Medicaid
Medicare Supplement vs. Medicare Advantage?
Medicare Supplement helps pay expenses not covered by traditional Medicare. Medicare Advantage replaces traditional Medicare and is offered by private insurers.
Who may qualify for Medicaid?
Eligibility may include children, pregnant women, seniors, certain parents/caretakers and individuals with qualifying disabilities subject to program requirements.
Network Coverage
In-Network vs. Out-of-Network?
In-network providers have contracts with insurers and usually lower costs. Out-of-network providers may result in higher patient responsibility.
Billing & Payments
Why did I receive more than one bill?
Different providers may bill separately for services such as physician, pathology, radiology, anesthesia and hospital charges.
Why is there still a balance after I paid?
Payments may still be processing or under review.
Can I make payments over time?
Payment plan options may be available.
Uninsured Patients & Financial Assistance
Are uninsured discounts available?
NMHS offers a 57% discount for uninsured patients.
Is financial assistance available?
Financial assistance programs may be available for qualifying patients.
What if I cannot afford my balance?
Contact the billing office to discuss assistance and payment options.
Estimates & Pricing
Can I get an estimate before services?
Yes. Estimates are available online or by calling (662) 377-4211.
Most Important Advice for Patients
What should I do when I receive a medical bill?
Review your bill and EOB, verify insurance information and contact the billing department with questions.
Your NMHS patient access specialist (PAS) can help answer questions about insurance and communicate with your insurance company. In most cases, you will be able to connect with a PAS at the hospital, clinic or facility where you are receiving care.