Many insurance companies require you or your doctor to obtain pre-admission certification, even for emergency admissions. Failing to do this will not prevent your child from receiving care, but you will be responsible for expenses incurred that your insurance company doesn't cover. You should also notify the hospital's admitting department immediately if any changes occur in your insurance coverage during your child's hospitalization.
If you have health insurance, as a courtesy, the hospital will bill your insurance company for you. To do so, we need your cooperation in obtaining the information and signatures needed to file a claim with your insurance company. If there is a difference between what they pay and the actual bill, you will be expected to pay that amount to CHKD.
If you are a member of an HMO or PPO, your plan may have special requirements, such as for a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met.
Newborn babies are usually eligible for coverage under your hospitalization policy, but only if they are added to your policy within 30 days of birth. It is your responsibility to contact your employer and your insurance carrier to enroll your child. If you need help, please contact our health benefits analysts immediately.
If you are covered by TRICARE, for all inpatient admissions, except bona fide emergencies, TRICARE requires a certificate of non-availability. For urgent admissions, we will assist you in applying for the certificate, which will be mailed to your residence by the Naval Regional Medical Center or other appropriate facility. It is your responsibility to provide a copy of it to the hospital and each physician providing services to your child. Each bill submitted to TRICARE must be accompanied by a copy of the certificate of non-availability, so please keep the original for your files and provide copies to the hospital and physician offices. TRICARE patients must pay a portion of the bill (cost sharing) directly to CHKD at the time of discharge. Copies of the TRICARE Handbook are available from the hospital admitting department or the patient financial services office.
TRICARE health benefits advisors are available at Naval Regional Medical Center, Portsmouth, (757) 953-2610; (757) 953-2611 and at the TRICARE Service Center, 800-931-9501.
Medicaid or Medicaid-related Insurance
If you are covered by Medicaid or Medicaid related insurance or State and Local Hospitalization (SLH), please provide the admitting department with the patient's identification card to be photocopied. If you are covered by Medicaid or Medicaid-related insurance, you must add your newborn to your Medicaid case. To do this, contact your Medicaid case worker and provide a verification of birth and proof that you have applied for a Social Security card. If you need help with Medicaid forms, please contact our health benefits analysts or our Medicaid eligibility office.
No Insurance/Inability to Pay
If you do not have insurance or are unable to make payment in full, please see one of our health benefits analysts for a confidential interview and assistance with your financial needs. The office is located on the first floor across from the admitting department and the outpatient registration area. You can call our health benefits analysts for assistance (757) 668-7202 or (757) 668-7174 or evenings/weekends, call (757) 668-7682.