Insurance plans
Many Atlantic Health locations are considered network participants with a variety of insurance companies, including those that are part of the Health Care Exchange (Affordable Care Act).
Most insurance carriers take 30 to 45 days to process a claim, after which the hospital will seek your assistance in getting paid. If a claim is not paid within 75 days, the hospital will consider the bill a patient responsibility.
You should verify the accuracy of any bill when you receive one, and compare statements from the hospital and insurance carrier to ensure that they are in agreement. You should follow up with the insurance carrier or hospital if you have not received a bill or notice of payment within 45 days of service.
Insurance carriers frequently deny claim submissions after 60 days, and payment for late submissions may be considered a patient responsibility. Please assist the hospital in appealing to the insurance carrier for any services that are not paid. You can also assist the hospital by promptly responding to Coordination of Benefits (COB) requests that you may receive from your insurance carrier. Your prompt payment of any deductible, coinsurance and/or co-pay is also appreciated. For questions or assistance, call 1-800-619-4024.
Pre-certification
Your insurance or managed care plan may require you to obtain pre-certification or pre-authorization for hospitalization, a procedure, surgery or service before they can be provided by the hospital and health care provider. Be certain to check this pre-certification requirement before your admission.
If you were admitted to the hospital through the emergency department, be sure that your insurance company is immediately notified of your admission. If you have any questions, please contact your insurance company or speak to your Atlantic Health care manager.
You will probably receive more than one bill for services rendered by the hospital. Usually, one bill is sent for the use of hospital equipment, supplies, your room and board, and the time the nurses and other staff spent meeting your health care needs. You are responsible for any charges not covered or approved by your medical insurance company or managed care organization. The hospital bill does not include fees of any treating physicians.
You may receive a separate bill from your personal physician and any other physician(s) involved in interpreting tests or performing other services. For example, a cardiologist, pathologist, radiologist or anesthesiologist will each send a separate bill for his or her professional services.
Participating insurance plans
Patients should always check with their individual carriers to determine the network status of Atlantic Health.
Health care exchange products
All Atlantic Health hospitals, including Morristown Medical Center, Overlook Medical Center, Newton Medical Center, Chilton Medical Center and Goryeb Children’s Hospital, participate in select Health Care Exchange (Affordable Care Act) insurance plans. Please note that these products may have an associated network of preferred providers, and as such, your benefits and potential out-of-pocket expenses may vary depending upon where and by whom care is provided. It is strongly recommended that you contact your plan in advance of seeking services in order to understand your potential financial liability.
Health Care Exchange insurance products currently accepted:
- Ambetter
- AmeriHealth NJ Tier 1 Advantage
- Horizon Blue Cross Blue Shield of New Jersey- Horizon Advantage EPO
- Horizon Blue Cross Blue Shield of New Jersey- Omnia Tier 1
- Oscar (when Qualcare Logo is present)
- UnitedHealthcare Exchange (Individual Exchange Benefit Plan and Oxford Metro)
Surprise bill protection & transparency
When you get emergency care you are protected from balance billing.
