We realize that health insurance coverage can be difficult to understand sometimes, and it is always best to contact your insurer when you have specific questions about your plan’s coverage.
To help ensure that any admission to Emerson Hospital is covered by your health insurance, however, here are some general guidelines:
Pre-admission certification
Most insurance companies require pre-admission certification before they will cover your hospitalization. This means:
- You or your doctor must obtain advance approval from your insurer for non-emergency admission to the hospital, or
- You must notify your insurer within 24 hours after an emergency admission
This pre-admission certification may be your responsibility for some commercial insurances. If you do not complete this process, you’ll be held responsible for the costs not covered by your insurance — so it is important to make sure you understand what’s required before you are admitted to the hospital.
Some other information about insurance coverage
- At the time of admission, you will be asked to provide current insurance information, cards and letters.
- Your insurance coverage, including Medicare/Medicaid and health maintenance organizations (HMOs), will be evaluated prior to the time you are admitted
- If your hospital bill is being paid by worker’s compensation, we will need verbal or written approval from the carrier before your claim can be processed
- If any part of your bill is not covered by insurance, it’s your responsibility to make arrangements for payment by cash, check, credit card or payment plan, prior to your scheduled admission. You can arrange this by calling 978-287-3432.
Observation patients and insurance coverage
If you are admitted to Emerson Hospital for observation, it is important that you check with your insurer to determine whether you’ve been approved for outpatient observation services. Insurers define observation as “outpatient,” which means you will be responsible for any deductible and insurance co-payments. For more information about coverage for observation, please call your insurer directly.
Insurances accepted by Emerson Hospital
Emerson Hospital accepts most major commercial insurances, as well as Medicare and Medicaid (MassHealth). Here is a complete list of insurance companies accepted at Emerson Hospital.
Special help for Medicare enrollees
If you are enrolled in Medicare, the Commonwealth of Massachusetts provides free information, counseling and assistance to you and your caregivers through the SHINE Program (Serving the Health Insurance Needs of Everyone). Specially trained counselors ensure that Massachusetts residents with Medicare and their caregivers have access to accurate, unbiased and up-to-date information about their healthcare options. For more information, visit the SHINE Program website.
Questions?
Please call our Financial Services office at 978-287-3432 between 8 a.m. and 5 p.m., Monday through Friday.
