DeKalb Medical Insurance and Payment Information

Important Payment Information

• Our cost of rendering care is based upon cash payment at the time of service.
• Payment is expected when services are rendered.  For your convenience, we accept cash, checks or credit cards.
• If you are covered by a managed health plan, your co-payment and/or deductible is due at the time of service.  Click here for a list of insurance plans accepted by DeKalb Medical. Patients without insurance will be asked for payment prior to treatment.  Your cooperation with our payment policy helps us provide quality medical care while controlling health care costs for all patients.
• Radiology Associates and Emergency Physician fees are billed separately.

Financial Assistance

For information on financial assistance to patients who qualify for uncompensated services, please call our Financial Counselors at 404.501.5555.  Assistance is determined by family income.

Hospitalization Insurance

DeKalb Medical accepts most insurance plans, provided we receive proof of coverage.  Once we have verified your insurance, a claim is issued for total charges. Your insurance company calculates the payment amount and pays us accordingly. In addition to this payment, your insurance company provides us with an explanation of benefits and your required amount.

If you are covered by more than one policy, we will process the claims for all companies. If there’s an overpayment on your account, we will make a refund within the time allowed by Georgia law for such transactions, to the appropriate party.

Please remember that your insurance policy is a contract between you and your insurance company. We will do our very best to see that you receive all the benefits to which you are entitled, but you are ultimately responsible for the payment of your account.

Precertification

Most insurance companies now require precertification for elective admissions and procedures. In other words, your stay must be determined to be medically necessary by your plan prior to your admission to the hospital. Only medically necessary services are deemed covered and payable by insurance carriers. If you are admitted without the necessary precertification, your insurance company could refuse to pay all or part of your hospital bill. Some plans require that certain surgical procedures be done on an outpatient basis. If you are unsure about these requirements, discuss them with your physician, your employers and your insurance company before you are admitted to the hospital.

Required Insurance Information

Based on your insurance provider, we ask that you provide the following information when you are admitted.

Group Insurance (HMO, PPO and Indemnity) – the mailing address for the claim and a copy of your current insurance card.

Individual Insurance – Acceptance of this type of insurance is based on your type of policy. Please speak with our Admissions Department prior to your admission.

Medicare and Medicaid – If you are a Medicare patient, we will need your Medicare card. If you are a Medicaid patient, please bring your current month’s Medicaid form.

Workers’ Compensation – Please provide the name, address and phone number of the employer, the name of the insurance company that will pay for your "on the job" injury, and the name and phone number of the contact person for authorization.

Active or Retired Military – Please bring your military ID card. Any dependent patient 10 years or age or older must present an ID card.

Insurance Plans Accepted

• HMO/ Aetna Open Access HMO
• Elect Choice/Aetna Open Access Elect Choice
• Aetna Select/Open Access Aetna Select
• Quality Point-of-Service (QPOS)
• Managed Choice POS
• USAccess
• Aetna Choice POS
• Aetna Choice POS II
• Aetna Open Access
• Managed Choice
• Open Choice PPO
• Traditional Choice
• Aetna Affordable Health Choices (PPO & Indemnity Plans)
• Aetna Golden Medicare Plan (HMO)
• Aetna Medicare Open Plan (PFFS)

• HMO
• POS
• PPO
• Indemnity
• BlueValue Secure Medicare Advantage HMO

• HMO/HMO Open Access
• POS/POS Open Access
• Open Access Plus/Open Access Plus In-Network
• Network Open Access
• PPO
• CIGNA Medicare PFFS

• HMO
• POS

• HMO
• POS
• OPEN ACCESS,
• PPO
• Choicecare PPO
• Humana Choice Medicare Advantage PPO
• Humana Gold Choice Medicare PFFS

• Choice/Choice Plus
• Select/Select Plus
• Options PPO
• Indemnity
• Definity
• Medicare Complete
• Medicare Complete Choice
• Evercare – Medicare Advantage
• Secure Horizons - Medicare Advantage