Frequently Asked Questions

Frequently Asked Questions

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If you do not find an answer to your question here, please contact a patient services representative from our customer service team. You will find a toll-free number listed on your statement or you may reference our business office contact information for the services about which you have questions using the links to the right.

Q: What address should I mail a payment to?

A: Patient payments may be mailed to:

Carilion Clinic
P.O. Box 824579
Philadelphia, PA 19182

All other patient billing correspondence should be sent to:

Carilion Clinic
P.O. Box 13966
Roanoke, VA 24038

Q: Can I see my account detail online?

A: Online access to patient billing detail is not currently available.

Q: Has my health insurance been billed for my claim?

A: Our billing teams will file your claim with the insurance information you provided at the time of registration. If possible, the claim will be submitted electronically for faster processing. If you feel that we may have incorrect insurance information, please contact our Customer Service team.

Q: What is this bill for and who should I contact with questions or concerns?

A: A bill generated from Carilion Clinic may include both hospital or hospital-based clinic/wellness center facility charges AND professional provider charges. As our hospitals and provider offices transition to our new billing system, more hospital and professional fees will be consolidated to this single billing format. Contact our Customer Service team with additional questions or concerns.

A bill generated from Carilion hospital billing services is from a Carilion hospital or hospital-based clinic or wellness center. Hospital charges are fees incurred for the use of the facility only and usually do not include professional charges for physician interpretations or visits. Contact our Customer Service team with additional questions or concerns.

A bill generated from Carilion professional billing services is from a Carilion physician or an out-patient clinic (sometimes located at the hospital). Professional charges are generally fees incurred for the provider's expertise and involvement in your care. Depending upon the location and services provided, some facility fees may be present on your professional bill. Contact our Customer Service team with additional questions or concerns.

A letter generated from Carilion Clinic with an account number prefix including the letters "PPS" is generally for balances that have not been resolved as quickly as expected.

These may represent both hospital and professional charges. Contact our Customer Service team with additional questions or concerns to ensure your account does not progress further into collection processes. Our patient service representatives are prepared to review several programs and payment options that may be helpful to you.

A statement from Carilion Debt Recovery Department generally represents balances for which our other departments have exhausted efforts to resolve your account. These may represent fees from a number of Carilion service lines. Contact our Debt Recovery team with additional questions or concerns.

A bill generated from Carilion Consolidated Laboratories or Carilion Labs includes fees incurred from lab and pathology sent by your provider for study. Contact Solstas Lab Partners with additional questions or concerns.

Q: Can I request a copy of my bill?

A: Yes, detailed itemized statements are available at your request. Claim forms are available in some cases. Contact our Customer Service team to make your request. We will mail the information to you as soon as possible. For hospital and professional services you may also choose to pick these up at the Carilion Payment Center, 1502 Williamson Road NE, in Roanoke.

Q: I've lost my health coverage. How may I obtain medically necessary services?

A. If you do not have health coverage, we will try to help you and your family find financial help or make other arrangements. We need your help with collecting needed information and other requirements to obtain coverage or assistance.

Q: My insurance company states that the bill was coded incorrectly. What does this mean and how can I have it corrected?

A: Medical claim forms are coded using a number system corresponding to a certain series for visits, tests, procedures and diagnoses. The system was designed to provide for uniform billing and claims processing while protecting patient confidentiality. Use of this system is mandated by the U.S. Department of Health and Human Services.

Occasionally, coding is not consistent with the procedure that was performed or with the diagnosis that was determined by your doctor. In this case, we suggest that you inform the appropriate business office by calling the toll free number. Any information you might provide regarding the conversation with your insurance company will prove helpful for our patient financial services representatives to research your concern. At times we find that the coding was completed correctly, but is simply excluded from coverage under the terms of specific insurance policies. Once such a scenario is determined through our research, your insurance company will be able to clarify any coverage limitations for the services you received. To prevent such a scenario, it is important to understand these same coverage limitations that may be unique to your policy and clarify beforehand with your medical provider what service you are seeking.

Q: My address has changed since I received treatment at Carilion. How can I change the address on my accounts and statements?

A: If your address has changed or statements are being sent to an incorrect address, please contact the appropriate business office so that we can correct the address on your account and have future billing statements mailed properly.

Q: Why did my insurance company not make a payment?

A: Insurance denials can result from many circumstances. The most common reason for insurance not making payment is due to policy deductibles which must be met before any benefits are payable. In addition, denials can result from policy limitations or exclusions for non-covered services under the policy. Even if a service is deemed to be covered, the insurance company may request additional information such as itemized statements, medical records or even a questionnaire from the insured regarding other coverage or pre-existing conditions before processing payment. When a claim is processed, you should receive an explanation of benefits from your carrier which will most likely define the reason for the denial (Medicaid excepted). For more information, you may want to reference your insurance policy or contact your insurance carrier for a detailed explanation.

Q: How may I better understand my insurance benefits?

A: Review your policy with either a representative from your insurance company or the health benefits manager with your employer. Ask questions regarding excluded services and responsibilities for obtaining authorization prior to treatment when possible.

Q: My insurance company states that I am not liable for the remaining balance on my account. Should there be an adjustment to my account?

A: Carilion Clinic participates with many managed care HMO and PPO plans as well as federal and state government programs. In addition, many local employers contract with Carilion to be the sole provider of service for their employees. In these situations, we may have a contract with the carrier to accept a payment that is less than the total charges (subject to co-pays, deductibles and non-covered services). When such an agreement is in place, Carilion will post a contractual adjustment discount to align the account balance with the negotiated price. The adjustments are usually posted to the account either at the time of billing or when the payment is received from the carrier. If you feel that you should have received a discount or your insurance states that you are not liable for any balance, please contact patient services so that we can research and correct the account.

If you did not find an answer to your question here, please contact a patient services representative with the business office associated with your account. You will find a toll-free number listed on your statement.

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