You go to your doctor, who refers you to a specialist, who sends you to the hospital for a bunch of tests and a procedure of some kind. A few weeks later, the bills start coming. Or are they statements? Or important-looking papers that say “This is not a bill”?

If they’re not bills or statements, why are you getting them?

These papers don’t all come at the same time or from the same place. One may be from a doctor you have never even seen or heard of, perhaps the radiologist who read your X-rays. Others may come from your insurance company and tell you what portion of each bill you might need to pay.

It can all be very confusing.
A couple of years ago, when FirstHealth of the Carolinas asked people in Montgomery County about their needs related to health care services, something they kept mentioning was how hard it can be to sort out their medical bills and figure out what they need to pay and when they need to pay it.

FirstHealth responded by creating the free Billing Adviser Program.

Since September 2004, a financial counselor from FirstHealth Moore Regional Hospital has been going to Montgomery Memorial Hospital one day twice a month to meet with people who need help understanding their medical bills.

“They don’t even have to be FirstHealth bills,” says Leslie Deane, FirstHealth’s director of Planning & Marketing, who helped start the Billing Adviser Program. “We know that some of the people we help didn’t come to a FirstHealth physician or hospital, but we decided it was the right thing to do. We had been asked, there was an obvious need, and we had the resources to meet that need.”

The Billing Adviser Program is a service to the community that FirstHealth provides as part of its responsibility as a not-forprofit organization. Jamie Smith, supervisor of Reimbursement Services at Moore Regional Hospital, set up and oversees the Montgomery County program.

“We sit down with people and go through all their medical bills and assess their situation,” he says. “We will contact all the different medical providers they have used to make sure that if they have insurance, it has been filed correctly and everything has been paid. We find out exactly how much, if anything, the patient needs to pay.”

If patients are unable to pay what they owe, the Billing Adviser counselor tries to help them get financial assistance. They may be referred to FirstHealth Cares, a program that helps people who can’t afford their medications get certain types of prescription drugs free of charge. (See related story on page 37.)

“We have found that a majority of people who bring their bills to us qualify for some type of assistance program,” says Gay Green, director of Patient Financial Services at Moore Regional. “They end up not owing a lot of their bills because of their income levels.”

Both Moore Regional and Richmond Memorial hospitals have full-time financial counselors to work with patients who need help paying their bills. A counselor determines whether a patient qualifies for Medicaid or some other source of assistance, such as the state’s Division of Vocational Rehabilitation.

“People sometimes think that eligibility for subsidized care is based solely on income, but that’s not so,” Green says. “You may make a very good salary, but all of a sudden you have a catastrophic illness and can’t work, and your wife or husband can’t work because he or she has to stay home and take care of you. We take those situations into consideration, and often we can provide some assistance.”

Sometimes patients don’t qualify for financial aid, but their hospital bill is so large that they can’t pay it all at once. In such cases, the hospital may set up an interest-free installment payment plan.

“We want people to pay as much as they can in a reasonable period of time,” Green says. “We don’t want a $10,000 bill hanging over somebody’s head for 10 years. We don’t want to put that burden on them. If the patient is unable to keep up with the payments, we will look into the reasons and determine whether part of their financial responsibility should be written off. If that’s the case, then we will set up a payment plan for the remainder of what they owe.

“If you find yourself in that situation, then please call us. Don’t let the bills pile up. If you can’t pay, we are going to do everything in our power to help you.”

For more information on the Billing Adviser Program in Montgomery County, FirstHealth Cares or other financial assistance counseling programs offered by FirstHealth of the Carolinas, please call (800) 213-3284 toll-free.