Billing and Insurance

Thank you for choosing Carlisle Regional Medical Center as your healthcare provider. The Administration and Medical Staffs of Carlisle Regional want to ensure that billing questions and concerns are addressed. We are aware of the confusing nature of insurance coverage. Therefore, we have developed this summary to explain our billing process.

Insurance & Payment Information

Health Insurance
As a courtesy to our patients, Carlisle Regional will file a claim directly with the insurance company. After the claim has been filed, the Business Office will follow-up with the claim’s payment status. If payment is not received from patient’s insurance provider within an appropriate time period, the patient will be informed in writing of his or her responsibilities. We encourage the patient to contact the Business Office at (717) 960-1680 if there are any questions or concerns regarding the insurance payments or the statements received in the mail.

Private Pay
Patients who do not carry health insurance are considered private pay accounts. These accounts are billed directly to the patient’s home. Carlisle Regional does provide discounts and payment plans upon request. For more information regarding the discounts and payment plans, please contact the Business Office between 8 a.m. and 4:30 p.m. at (717) 960-1680.

Please be advised, for those individuals who do not carry insurance and are treated in the Emergency Room, upfront payment will be collected at the time of service.

Auto/Worker’s Comp Insurance

Please tell us if your visit is a result of an auto accident or work injury the day you come to Carlisle Regional.

Deductible

  • A fixed dollar amount set by the insurance company that is required of the patient over the course of a benefit period.
  • Deductibles are not always met with one date of service; it may require multiple medical visits and services before the patient meets the annual deductible amount.
  • Depending on the patient’s insurance and the circumstances for which the patient has arrived at Carlisle Regional (i.e. inpatient, emergency room, and surgery) the deductible amount may be required at the time of service.
  • The deductible may be collected at the time of service.

Co-Pay

  • A small fixed dollar amount assigned by the insurance company and required of the patient.
  • Co-pays will be collected at the time of service.

Coinsurance

  • A percentage of the total bill assigned as patient responsibility by the insurance company.
  • The coinsurance may be collected at the time of service.

Please note, if an insurance company assigns the patient a deductible, co-pay, or coinsurance and the dollar amount is not collected at the time of service, the patient will be billed at a later date.

Emergency Room Billing

  • A Nurse will assess ALL Emergency Room (ER) patients.
  • The ER Nurse will establish the order in which patients will be seen for medical assistance based on her professional assessment of the patient’s symptoms and vital signs.
  • Vital signs that will be taken: blood pressure, temperature, respirations and oxygen levels (as necessary).
  • All patients will be billed for this professional service.
  • Wait times vary depending on the number of patients and the severity of each patient’s medical needs.
  • Please note if you leave the ER prior to receiving additional medical services, you will be responsible for the services provided during triage.

Emergency Room Follow-Up

Please review your discharge instructions closely. If you return to the Emergency Room for a routine/non-urgent follow-up care (i.e. removal of stitches), you will be billed for the use of the ER, supplies, and Carlisle Regional professional staff.

Additional Billing

In addition to your Carlisle Regional bill, you may receive a bill from one or more of the following contracted physician services that provided care:

Kinetic Imaging—PCMS

  • Physician services for imaging procedures such as X-ray, MRI, CT Scan, and ultrasound.
  • For billing questions call: (717) 652-6105.

Blue Mountain Anesthesia Associates

  • Physician anesthesia services.
  • For billing questions call: (800) 827-3458 ext. 716.

Emergency Department / Emergency Room Physicians

  • For billing questions please call Tammy Ritter: (717) 960-3394.

Central Penn Medical Group (CPMG)

  • Hospitalist and physician services.
  • Certified nurse anesthesia services.
  • For billing questions call: (877) 205-3879.

Carlisle Medical Pathology

  • Physician services for laboratory testing and results.
  • For billing questions call: (800) 823-5114.

Note: Your primary care physician and other specialists may also bill you for their services. For questions, call the number printed on these individual bills.

Pricing Information Representatives Now Available to Patients and Physicians

Carlisle Regional Medical Center has recently appointed Pricing Information Representatives. Their main objective is to answer any patient and physician questions regarding the cost of receiving Carlisle Regional services.

By providing this service Carlisle Regional hopes to eliminate confusion associated with the cost of using the Hospital and to allow patients to make better informed decisions in choosing where they will receive services. To do this, the Pricing Information Representatives use information they have about CRMC pricing and the patient’s specific insurance plan to then calculate the best estimate of what the patient will owe the Hospital after their insurance pays.

The Pricing Information Representatives can be reached at (717) 960-3304 or (717) 960-3308.