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 from William P. Clements Jr. University Hospital or Zale Lipshy University Hospital, please call Patient Financial Services at 469-291-2700 or toll-free at 866-590-2198; if you prefer, email us the inquiry at pfshospitalbill@utsouthwestern.edu.

For questions regarding a bill from a UT Southwestern clinic, please call Account Services for Physician Billing at 469-291-2000 or toll-free at 866-648-2455, or email us at mybill@utsouthwestern.edu.

  1. What do I need to bring with me when I come to UT Southwestern?
  2. What health plans are accepted?
  3. Do I need a referral to see a health care provider at UT Southwestern?
  4. My insurance plan requires a copayment. Will I be required to pay the copayment when I check in for my appointment?
  5. How will I find out how much I owe?
  6. How is my insurance company billed?
  7. Who is responsible for paying the bill?
  8. I want to receive service from a UT Southwestern provider, but I know my insurance will not cover it. Is there any way to find out how much the service will cost?
  9. 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?
  10. I cannot pay my whole bill at one time. Can I make payment arrangements?
  11. How can I find out whether my insurance has paid?
  12. What if there is an error in my bill?
  13. Why do I have a hospital (facility) charge when I was seen in the clinic only?
  14. Why do I need to call my insurance company if they do not pay the bill?
  15. I have a question that is not on this list. How do I get answers?
Q:

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

A:

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.

Optional:

  • 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.

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Q:

What health plans are accepted?

A:

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.

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Q:

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

A:

Patients may make an appointment with a UT Southwestern specialist without a doctor’s referral. However, coordination of your health care may be improved when your doctor provides us with information regarding your condition prior to the initial visit. For this reason, some UT Southwestern specialists may request information or a referral from your doctor before seeing you.

Patients do need an insurance referral from their primary care physician if it’s required by their insurance plan. 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 the insurance company’s member service department. The phone number should be on the 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.

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Q:

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

A:

Yes. Copayments are collected at the time services are provided. For your convenience, we accept cash, 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.

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Q:

How will I find out how much I owe?

A:

The patient will receive monthly statements from UT Southwestern Medical Center. This may include two different statements: 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

This bill is for services provided at UT Southwestern University Hospitals & Clinics facilities. Charges for room, surgical suite, equipment, medications, diagnostic testing, and supplies for treatments or procedures conducted in any of the areas below appear on this bill.

  • University Hospital Aston Infusion Clinic
  • University Hospital Aston Physical Medicine & Rehabilitation Clinic
  • University Hospital Clinical Laboratory Services
  • University Hospital Cystic Fibrosis Clinic
  • University Hospital Diabetes Management
  • University Hospital Harold C. Simmons Cancer Clinics
  • University Hospital Bone Marrow Transplantation/Hematologic Malignancies Clinic at Simmons Cancer Center
  • University Hospital Center for Breast Care at Simmons Cancer Center
  • University Hospital Medical Oncology Clinic at Simmons Cancer Center
  • University Hospital Radiation Oncology Clinic at Simmons Cancer Center
  • University Hospital Surgical Oncology Clinic at Simmons Cancer Center
  • University Hospital Heart & Lung Clinic
  • University Hospital Heart Clinic – Texas Health Fort Worth
  • University Hospital Imaging Services
  • University Hospital Kidney & Liver Clinic
  • University Hospital Physical Medicine & Rehabilitation
  • University Hospital Sleep & Breathing Disorders
  • University Hospital Wound Care Clinic
  • William P. Clements Jr. University Hospital
  • Zale Lipshy University Hospital

The first statement provides the details of services received and the amount billed to the insurance company. Follow-up statements are sent after insurance payments are made and there’s a balance due from the patient.

Please direct any questions regarding billing, charges, or denied claims to Patient Financial Services at:

  • 469-291-2700
  • 866-590-2198 (toll-free)

You can also email us at pfshospitalbill@utsouthwestern.edu.

Please send payments to:

UT Southwestern University Hospitals & Clinics
P.O. Box 849928
Dallas, TX 75284-9928

UT Southwestern Medical Service Plan

This bill is for services provided by UT Southwestern physicians, physician assistants, and nurse practitioners. Statements from UT Southwestern Medical Service Plan itemize the services received, the amount paid by insurance, and the amount the patient owes.

Please direct any questions regarding billing, charges, or denied claims to 214-645-0600 or toll-free to 866-648-2455, or email us at mybill@utsouthwestern.edu.

Please send payments to:

UT Southwestern Medical Service Plan
P.O. Box 845347
Dallas, TX 75284-5347

The patient may also 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.

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Q:

How is my insurance company billed?

A:

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 statements.

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Q:

Who’s responsible for paying the bill?

A:

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.

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Q:

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?

A:

Yes, UT Southwestern staff can give an estimate. The patient may have to visit a UT Southwestern physician first to find out the specific services needed. Please remember that charges may vary based upon the medical condition. We also may not be able to schedule services until the estimate is complete.

Patients without insurance are eligible for a 25 percent discount for medically necessary services. Medications and supplies are excluded.

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Q:

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?

A:

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.

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Q:

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

A:

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 service representatives will work with the patient to arrange a payment plan if special circumstances prevent the patient from making a full payment.

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Q:

How can I find out whether my insurance has paid?

A:

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.

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Q:

What if there’s an error in my bill?

A:

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

  • 214-645-0600
  • 866-648-2455 (toll-free)

We will be happy to discuss any concerns.

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Q:

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

A:

The UT Southwestern Clinics listed below are classified as hospital-based facilities. Charges for services such as surgical suite, use of specialized equipment, medications, diagnostic testing, and supplies for treatments or procedures are billed by UT Southwestern University Hospitals & Clinics:

  • University Hospital Aston Infusion Clinic
  • University Hospital Aston Physical Medicine & Rehabilitation Clinic
  • University Hospital Clinical Laboratory Services
  • University Hospital Cystic Fibrosis Clinic
  • University Hospital Diabetes Management
  • University Hospital Harold C. Simmons Cancer Clinics
  • University Hospital Bone Marrow Transplantation/Hematologic Malignancies Clinic at Simmons Cancer Center
  • University Hospital Center for Breast Care at Simmons Cancer Center
  • University Hospital Medical Oncology Clinic at Simmons Cancer Center
  • University Hospital Radiation Oncology Clinic at Simmons Cancer Center
  • University Hospital Surgical Oncology Clinic at Simmons Cancer Center
  • University Hospital Heart & Lung Clinic
  • University Hospital Heart Clinic – Texas Health Fort Worth
  • University Hospital Imaging Services
  • University Hospital Kidney & Liver Clinic
  • University Hospital Physical Medicine & Rehabilitation
  • University Hospital Sleep & Breathing Disorders
  • University Hospital Wound Care Clinic

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Q:

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

A:

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. If it has not received the claim, please contact us:

UT Southwestern University Hospitals and Clinics

214-645-4500 or 866-590-2198 (toll-free)

UT Southwestern Medical Service Plan

214-645-0600 or 866-648-2455 (toll-free)

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.

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Q:

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

A:

Please ask us! Patient questions are our concern, so patients should feel free to ask a doctor, nurse, and clinic staff any questions they may have. Our staff can help with any questions about medical care, insurance benefits, and appointment scheduling.

For further assistance with hospital billing questions, please contact Patient Financial Services at 214-645-4500 or toll-free at 800-590-2198. Service representatives are available 8 a.m.–4 p.m. weekdays. 

For questions about physician services performed in UT Southwestern University Hospitals & Clinics, regular office visits, in-office procedures, and diagnostic test interpretation, call Account Services at 214-645-0600 or toll-free 866-648-2455. Service representatives are available 8 a.m.–6 p.m. Monday–Friday.

Patients may also email questions to mybill@utsouthwestern.edu.

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

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