Billing and Insurance Frequently
Asked Questions

At UT Southwestern Medical Center we realize that seeking medical help for an illness or undergoing a comprehensive examination can be stressful. We want to help ease that stress, so below are answers to some of the more common questions we receive about billing and insurance.

For answers to other questions regarding a bill, call the Account Resolution Department at 469-291-2000 (toll-free outside the Dallas area 866-648-2455) or email us the inquiry at billinginquiries@utsouthwestern.edu.

At My Visit

Statements

Insurance Coverage

Payment Plans

More Information

At My Visit

What do I need to bring with me when I come to UT Southwestern?

Essential:

  • A photo ID such as a driver’s license. We require this for your protection.
  • Medical documentation requested by your physician such as X-rays, lab results, pathology reports, and medical records such as immunization records.
  • Your current insurance card (for both primary and secondary insurance coverage).
  • An insurance referral or authorization from the patient’s primary care physician, if required by the insurance plan. Referrals are usually required for Aetna HMO, CIGNA HMO, HMO Blue, and Parkland Health First.
  • Method of payment for any copayments, deductibles, or coinsurance.

Recommended:

  • Copy of current advance directive. UT Southwestern accepts written advance directives. Patients with advance directives such as a Directive to Physician and Family of Surrogates (Living Will) or Medical Power of Attorney should ask that the advance directive be forwarded to the Health Information Management Department.
  • List of current medications that includes the dosage and how often taken.

Return to Top

What health plans are accepted?

UT Southwestern accepts most major insurance plans. View a list of the insurance plans we currently accept.

Not all UT Southwestern faculty providers participate in all plans. Please contact the UT Southwestern clinical practice or hospital where the patient wishes to be scheduled to verify that the patient’s plan is accepted.

Return to Top

Do I need a referral to see a health care provider at UT Southwestern?

Some of our UT Southwestern specialists do require a referral, as coordination of your health care may be improved when your doctor provides us with information regarding your condition prior to the initial visit. Additionally, some insurance plans require a referral from the patient’s primary care physician when seeing a specialist.

It is the patient’s responsibility to obtain a referral, if required. If you’re unsure whether an insurance referral is needed for your visit, contact your insurance company’s member service department. The phone number is usually listed on your insurance card.

Common plans that require insurance referrals are Aetna HMO, CIGNA HMO, HMO Blue, and Parkland Health First. Medicare patients do not need insurance referrals.

Return to Top

My insurance plan requires a copayment. Will I be required to pay the copayment when I check in for my appointment?

Yes. Copayments are collected at the time services are provided. For your convenience, we accept checks, Visa, MasterCard, Discover, and American Express.

The patient should also be prepared to pay for services not covered by insurance. We may ask for payment in full at the time of service for cosmetic care, elective care, or supplies not covered by insurance.

Return to Top

Can I get an estimate of my out-of-pocket costs?

Yes, estimates are available for in-clinic services, labs and imaging, and in-patient (hospital) stays and services. The finance staff in our clinics can help you obtain this information. Please note that the patient may have to visit a UT Southwestern physician first to find out the specific services needed. Also remember that charges may vary based upon the medical condition. We may not be able to schedule services until the estimate is complete.

Statements

Following my appointment, how will I find out how much I owe?

After your appointment, UT Southwestern will file a claim with your insurance company. Once insurance payments are made, the patient is responsible for any remaining deductible, copayments, coinsurance, and non-covered services. If there is a balance due, we will send you a follow-up statement that shows how much you owe.

The patient will receive ONE monthly statement from UT Southwestern Medical Center. This may include two different components: one for hospital services (UT Southwestern University Hospitals & Clinics), and one for physician and health care provider services (UT Southwestern Medical Service Plan).

UT Southwestern University Hospitals and Clinics

Services provided at any of our UT Southwestern University Hospitals and Clinics facilities are billed against your hospital benefit. This means you may have to pay your hospital copay in addition to your office visit copay and that your out-of-pocket costs may be higher, depending on your hospital deductible or other elements of your insurance plan. Charges for equipment, medications, diagnostic testing, and supplies for treatments or procedures conducted in any of the areas below appear on this bill:

  • University Hospital Outpatient Imaging Services
  • University Hospital Outpatient Laboratory Services
  • University Hospital Diabetes Education
  • University Hospital Infusion Center – Aston
  • University Hospital Physical Medicine and Rehabilitation Clinics
  • University Hospital Heart & Lung Clinic
  • University Hospital Kidney & Liver Clinic
  • University Hospital Sleep & Breathing Disorders Clinic
  • University Hospital Wound Care Clinic
  • Harold C. Simmons Comprehensive Cancer Center clinics
    • University Hospital Bone Marrow Transplantation/Hematologic Malignancies Clinic
    • University Hospital Center for Breast Care
    • University Hospital Infusion Clinic
    • University Hospital Medical Oncology Clinic
    • University Hospital Gynecological Oncology Clinic
    • University Hospital Radiation Oncology Clinic
    • University Hospital Radiation Oncology Clinic West
    • University Hospital Surgical Oncology Clinic

Statements from other providers or facilities

The patient may receive statements from laboratories, imaging facilities, ER physicians, or other professionals for services received during the visit. It is a legal requirement for these providers to submit separate bills for their services. We do not have access to their billing information. Please contact them directly with any questions about those statements.

The patient may also receive statements from Parkland Health and Hospital System or Children’s Health (Children’s Medical Center) after seeing one of our faculty members who practice there. We do not have access to billing information for Parkland or Children’s. Please contact them directly with any questions about those statements.

Return to Top

Who’s responsible for paying the bill?

The patient is financially responsible for the services received at UT Southwestern Medical Center. Even though the patient has health insurance, he or she is responsible for any part of the bill the insurance plan does not pay.

If the patient has an HMO, PPO, and other commercial insurance, he or she is responsible for all copayments, deductibles, and coinsurance at the time of services.

If the patient has Medicare but does not have supplemental or secondary insurance, he or she may also be responsible for copayments, deductibles, and coinsurance at the time of service.

If the patient does not have insurance or if the patient received non-covered services, he or she is expected to pay at the time of service. Patients are also eligible for a self-pay discount. Written policies on Discounting for Self-Pay and Uninsured Patients are available upon request.

Return to Top

What if there’s an error in my bill?

If you believe that your bill is incorrect, please call us at:

469-291-2000 (Toll free 866-648-2455)

We will be happy to discuss any concerns.

Return to Top

Why is there a charge on my bill for a doctor I did not see?

If there is a line-item charge on your statement for a physician you did not see, it is likely for professional services rendered by a doctor or specialist who diagnosed or interpreted test results. These providers may include radiologists, pathologists, cardiologists, anesthesiologists, or other diagnosticians. 

Return to Top

Why do I have a hospital (facility) charge when I was seen in the clinic only?

UT Southwestern Medical Center has a number of outpatient clinics and services that are hospital based. Services provided at our UT Southwestern University Hospitals clinics and services are billed against your hospital benefit. This means you will pay your hospital copay and that your out-of-pocket costs may be higher.

PLEASE NOTE that your statement from your insurance company may list these clinic, imaging, or lab appointments as a visit to one of our two hospitals (Clements University Hospital or Zale Lipshy University Hospital) or, in some cases, as a visit to the emergency room or department of these hospitals. This is based on the insurance company’s coding of visits to our hospital-based facilities.

Charges for equipment, medications, diagnostic testing, and supplies for treatments or procedures conducted in any of the areas below will be charged against your hospital benefit:

  • University Hospital Outpatient Imaging Services
  • University Hospital Outpatient Laboratory Services
  • University Hospital Diabetes Education
  • University Hospital Infusion Center – Aston
  • University Hospital Physical Medicine and Rehabilitation Clinics
  • University Hospital Heart & Lung Clinic
  • University Hospital Kidney & Liver Clinic
  • University Hospital Sleep & Breathing Disorders Clinic
  • University Hospital Wound Care Clinic
  • Harold C. Simmons Comprehensive Cancer Center
    • University Hospital Bone Marrow Transplantation/Hematologic Malignancies Clinic
    • University Hospital Center for Breast Care
    • University Hospital Infusion Clinic
    • University Hospital Medical Oncology Clinic
    • University Hospital Gynecological Oncology Clinic
    • University Hospital Radiation Oncology Clinic
    • University Hospital Radiation Oncology Clinic West
    • University Hospital Surgical Oncology Clinic 

Insurance

How is my insurance company billed?

UT Southwestern submits all items covered by insurance to the patient’s insurance company. It is very important that the patient provides current and accurate insurance information. Usually, the insurance company will pay us directly. If the patient has insurance, he or she needs to assign the insurance benefits to UT Southwestern. UT Southwestern bills the patient’s insurance only when benefits are assigned.

If we have a contract with the insurance company, we will honor its allowances for the patient’s charges.

We file supplemental insurance if the information is provided and benefits are assigned at the time of service.

The patient is responsible for the deductible, copayments, coinsurance, and non-covered services. These amounts will appear on the patient’s monthly UT Southwestern Medical Center statement.

Return to Top

How can I find out whether my insurance has paid?

When the insurance company responds to the claim, the patient receives an Explanation of Benefits (EOB). The EOB contains detailed payment information, including the portion of the bill that the patient must pay. Questions about the EOB, or disputes with the amount paid, should be directed to the insurance company. We’re happy to share any information we receive from the insurance company.

Return to Top 

I want to receive service from a UT Southwestern provider, but I know my insurance won’t cover it. Is there any way to find out how much the service will cost?

Yes, estimates are available for in-clinic services, labs and imaging, and in-patient (hospital) stays and services. The finance staff in our clinics can help you obtain this information. Please note that the patient may have to visit a UT Southwestern physician first to find out the specific services needed. Also remember that charges may vary based upon the medical condition. We may not be able to schedule services until the estimate is complete.

Patients without insurance are eligible for a self-pay discount.

Return to Top

My provider has ordered a specific test or procedure. Do I need to receive authorization from my insurance company before I can have this test/procedure done?

If our doctors prescribe care that needs prior authorization, we will gladly work with the patient to obtain the required authorizations and pre-certifications.

Services that frequently require authorizations include: advanced diagnostic imaging services (such as a CAT or PET scan or an MRI), inpatient hospital stays, and durable medical equipment (DME).

It’s best to direct specific coverage questions to the insurance company’s member service department. The telephone number should be on the insurance card.

Return to Top

Why do I need to call my insurance company if it doesn't pay the bill?

The insurance company has the most accurate and up-to-date information about the policy and claim. Insurance agents can tell you if the procedure or service received is covered by the policy. The insurance company can also verify that it received and processed the claim.

We make every effort to collect payment from the insurance company, but we may need the patient’s assistance to resolve any concerns or to obtain payment from the insurance company.

Return to Top

Payment Plans

I can’t pay my whole bill at one time. Can I make payment arrangements?

In most cases, full payment of the bill is due 25 to 30 days after the patient receives a statement showing a balance is due. Our Customer Account Analysts will work with the patient to arrange a payment plan if special circumstances prevent the patient from making a full payment.

Return to Top

More Information 

I have a question that’s not on this list. How do I get answers?

Please ask us! Our staff can help with any questions about billing or insurance.

For further assistance with billing questions, please contact our Account Resolutions Department at 469-291-2000 (Toll free: 866-648-2455 Customer Account Analysts are available 8 a.m. – 5 p.m. weekdays. 

The billing staff can answer questions about insurance payments, assist with insurance appeals, provide copies of statements, and establish payment arrangements.

Return to Top

How will I find out how much I owe?

You will receive a monthly statement from UT Southwestern Medical Center. If you are enrolled in MyChart, our secure online health management tool, you will receive this as an electronic document within MyChart. You will not get a paper statement in the mail unless you specifically request that option.

If you are not currently enrolled in MyChart, you will get a paper statement in the mail each month. To switch to an electronic statement, you will need to sign up for MyChart. Due to security and privacy considerations, we cannot email you a statement.

Your monthly statement will itemize the services received, the amount paid by insurance, and the amount the patient owes.

For more information, call our Account Resolutions Department at 469-291-2000 (Toll free: 866-648-2455).

PLEASE NOTE that you may also still receive additional statements from independent laboratories, physicians, or other third party providers affiliated with, but not employed by, UT Southwestern. Because these professionals are independent contractors, we do not have access to their billing information. It is a legal requirement for these providers to submit separate bills for their services, rather than combine them with your single bill from UT Southwestern Medical Center.

Return to Top