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If the FAQs do not have an answer to your question, feel free to contact us at webmaster@LGHealth.org.
Category:
Advance Directives
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What are my rights to accept, reject or stop medical care or treatment?
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In Pennsylvania, adults generally have the right to decide if they want to accept, to reject or to discontinue medical care and treatment. In order to protect and safeguard this right, however, it may be necessary to execute an advance directive for health care (also known as a living will) and/or a durable power of attorney for health care. For example, under a criminal law known as Act 28 of 1995, caretakers such as owners, managers, or employees of nursing homes and other health institutions have an affirmative duty to provide necessary medical care to individuals within their care. Caretakers are relieved of this duty only if they can demonstrate that the patient has competently refused the medical care or treatment, or the person, if incompetent, previously executed a living will or durable power of attorney for health care indicating that he or she does not wish to receive medical care or treatment in question.
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What does my doctor have to tell me about my care and treatment?
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Your doctor should provide you with all of the information which a person in your situation reasonably would want to know in order to make an informed decision about a proposed procedure or course of treatment. This means that your doctor should tell you about the risks and benefits of the medical procedure or course of treatment which he or she is recommending, possible side effects, and alternatives, if any, to the proposed procedure or course of treatment. Your may accept or reject your doctor's advice and you may seek a second opinion.
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Does my health care provider have to tell me if it will not honor my wishes?
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Yes. The law requires your health care provider (hospital, nursing home, home health care service, hospice or HMO) to give you a written statement of its policies. For example, upon admission to a hospital, you must be informed as to whether the hospital will not honor your wish to have food and water withheld or withdrawn under certain circumstances.
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If I become physically or mentally unable to make a decision about my medical care or treatment, what can I do now to guarantee that my wishes will be followed later?
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There is no law in Pennsylvania which guarantees that a health care provider will follow your instructions in every circumstance. There are, however, steps you can take to express your wishes about future treatment. One of these steps is to write and sign an advance directive.
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What is an advance directive?
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An advance directive is a written document that you may use, under certain circumstances, to tell others what care you would like to receive or not receive should you become unable to express your wishes at some time in the future. An advance directive may take many forms. In Pennsylvania, two types are specifically authorized: (1) a living will, also known as an advance directive for health care and (2) a durable power of attorney for health care.
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What is a living will?
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In Pennsylvania, a living will is a written document that describes the kind of life-sustaining treatment you want or do not want if you are later unable to tell your doctor what kind of treatment you wish to receive. For your convenience, here is a printable sample living will. It is important for you to know that Pennsylvania's living will does not recognize all types of instructions which might be contained in a person's living will. Rather, instructions must relate to situations where medical treatment would serve only to prolong the process of dying or to maintain you in a state of permanent unconsciousness. A living will would apply only in cases where your condition or illness is terminal or you are permanently unconscious. So, for example, Pennsylvania does not specifically recognize living wills which direct a health care provider to withhold medically beneficial, nonfutile care.
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You should also understand that a living will is not a last will and testament.
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Who can make a living will?
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When does a living will take effect?
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What does it mean to be "incompetent"?
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What should my living will contain?
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There is no single correct way to write a living will. Your living will may have additional or different directions than the sample living will. Your living will is not valid, however, unless you have taken the following steps:
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You must sign your living will. If you are unable to do so, you must have someone sign it for you; and
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Two people who are at least 18 years old must sign your living will as witnesses. Neither of those witnesses may be the person who signed your living will on your behalf if you are unable to sign it yourself.
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You should also date your living will, even though the law does not require it. In Pennsylvania, you are not required to have your living will notarized, however, if you are contemplating using the document in another state your should find out if the other state requires notarization.
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What if I already have a living will?
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To whom should I give a living will?
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You should give a copy of your living will to your doctor, hospital, nursing home or other health care provider. When you enter a hospital or nursing facility, the law requires your doctor or other health care provider to ask you if you have a living will. If you give a copy of your living will to your doctor or other health care provider, that document must be made part of your medical record. You may also want to give a copy to an immediate family member or a close friend.
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What if my doctor or health care provider refuses to follow the directions in my living will?
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Your doctor and any other health care provider must inform you if they cannot in good conscience follow your wishes or if the policies of the institution prevent them from honoring your wishes. This is one reason why you should give a copy of your living will to your doctor or to those in charge of your medical care and treatment.
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If you are incompetent when you are admitted for medical care and have named someone in your living will to make decisions for you, that person must be informed if the wishes contained in your living will cannot be honored. If you have not named anyone in your living will, your family, guardian or other representative must be informed that your living will cannot be honored.
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The doctor or other health care provider who cannot honor your wishes must then help transfer you to another health care provider willing to carry out your directions--if they are the kind of directions which Pennsylvania recognizes as valid.
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Is a living will effective when I am pregnant?
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Pennsylvania law generally does not permit a doctor or other health care provider to honor the living will of a pregnant woman who has directed that she not be kept alive. The terms of such a living will may be honored, however, if the woman's doctor determines that life-sustaining treatment: 1) will not maintain the woman in a manner that will allow for the continued development and birth of the unborn child; 2) will physically harm the pregnant woman; or 3) cause her pain which could not be relieved by medication. If your living will is not honored because you are pregnant, the Commonwealth must pay all usual, customary and reasonable expenses of your care.
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What if I change my mind after I have written a living will?
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Pennsylvania's living will law states that you may revoke a living will at any time and in any manner. All that your must do is tell your doctor or other health care provider that you are revoking it. Someone who saw or heard you revoke your living will may also tell your doctor or other health care provider. You can also change or rewrite your living will. If you change your mind after you have written down your instructions, you should destroy your written instructions and all copies or revoke them and write new ones. You should also consider telling everyone who participated in your decision-making process that you have changed your mind and give them a copy of any new instructions to your doctor, health care provider, and anyone else who had a copy of your old instructions.
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What is a durable power of attorney for health care?
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A durable power of attorney for health care is a document which allows you (the principal) to name another person (the attorney-in-fact) to make certain medical decisions for you if you are unable to make them for yourself. The person you choose as your attorney-in-fact does not have to be a lawyer. The law says that the attorney-in-fact can:
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authorize your admission to a medical, nursing, residential or other facility;
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enter into agreements for your care; and
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authorize medical and surgical procedures.
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The power to "authorize medical and surgical procedures" means that your attorney-in-fact may arrange for and consent to medical, therapeutic, and surgical procedures for you, including the administration of drugs.
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As of this writing, courts in Pennsylvania have not decided if the law permits an attorney-in-fact to refuse treatment on your behalf, especially if the attorney-in-fact is refusing potentially beneficial care.
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Why do they call it a "durable power of attorney"?
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What are some of the major differences between a living will and a durable power of attorney?
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Unlike a durable power of attorney for health care, a living will only takes effect when you are in a terminal condition or permanent state of unconsciousness.
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A durable power of attorney for health care generally names someone to make healthcare decisions for you without necessarily describing what those decisions should be. A living will, on the other hand, often spells out what kind of life-sustaining treatment you want to receive and may or may or may not name someone to make those decisions for you. Unlike a durable power of attorney for health care, a living will only takes effect when you are in a terminal condition or permanent state of unconsciousness.
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A durable power of attorney for healthcare is designed to give your named representative authority to make all sorts of medical care decisions for you. A living will is generally used to tell your healthcare provider what kind of medical care and treatment you want to receive or not receive in the event you bec
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May I have both a durable power of attorney for health care and a living will?
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Yes, you many have both in either one document or in separate documents, although having both in one document may be recommended in many cases. There are certain factors you should consider in making the decision to have both, or either of these documents.
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Because the grant of powers in a durable power of attorney for health care may be very broad and will continue even if you become incompetent, it is very important that you exercise great care in both selecting the person to be your attorney-in-fact and in spelling out the power and guidelines for the attorney-in-fact to follow. While the grant of powers in a living will is more specific, great care should still be taken in both writing your living will and especially in selecting a surrogate if you decide to select one.
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What if I wish to donate my organs or other body parts after my death? Can I include this wish in my living will?
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Yes. If you are at least 18 years old, you may make an anatomical gift of the entire body or of body parts (including organs, tissues, eyes, bones, arteries, or blood) by expressing an intent to do so in your living will. You may also grant your attorney-in-fact the specific power to make and anatomical donation in a durable power of attorney for health care.
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With whom should I discuss my instructions before I write them down?
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Before you write your instructions down, you may wish to discuss them with your doctor, member of your family, friends or other appropriate persons, such as a member of the clergy. If you are writing a durable power of attorney for health care, you should also discuss your wishes with the person you are naming as your attorney-in-fact. Similarly, if you are writing a living will and naming someone in that document to carry out your wishes, you should discuss your wishes with that person.
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To whom should I give my written instructions?
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You should give your written instructions to your family doctor and, if applicable, to your hospital, nursing home or other health care provider. You may also want to give a copy to your family or anyone else involved in your health care decision-making process, and you should also keep a copy for your own records.
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What if I don't leave instructions or name a person who will make a decision for me?
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What if I have expressed my wishes orally about treatment, but have not put my wishes in writing?
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Oral directions which you have given to your physician or your family will sometimes be followed by health care providers, depending on how detailed and recent those instructions were. Thus, you may wish to tell your personal physician and your family your wishes about future treatment, even if you choose not to sign some sort of advance directive.
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Do I have to write a living will or durable power of attorney for health care?
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No. It's your decision. Under the law, a health care provider may not determine the type of care needed for you, or otherwise discriminate against you, on the basis of whether you have written such a document. Moreover, under Pennsylvania law, not health care provider or insurer may charge a different fee or rate depending on whether you have executed a living will.
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Are living wills and durable powers of attorney which were written in other states recognized in Pennsylvania?
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The law in Pennsylvania is unclear. It is possible, however, that at the very least your doctor, hospital or a judge may use such documents to determine who will make decisions about your care and what those decisions will be.
Billing
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I want to come to Lancaster General Health for care, but you do not accept my insurance. Why not?
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Who do I contact if I have a billing question?
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Online you can review billing information on our Patient Billing page. Here you will find helpful information about billing. If you want to speak to a representative, please call (717) 544-4953 or 1-800-647-4419.
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Why am I asked to provide insurance information to Lancaster General Hospital every time I come in for a service?
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Lancaster General Hospital is committed to providing high quality service from the point of registration through the billing after the service. Many of our customers have a change in insurance plans on a regular basis. This happens for a variety of reasons such as a job change, employer changes carriers, the customer chooses a different plan to meet their healthcare needs etc. Often patients think that if they have given their insurance information to their doctor or another provider, we have access to this information. This is more often than not an incorrect assumption. Our goal is to get it right the first time so that the customer is not trying to clear up billing down the road. The few extra minutes it takes to verify that we have the correct insurance information at every visit can save the customer much more time down the road.
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Why should I bring my insurance card with me for every visit?
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Your insurance card contains valuable billing information. We use this information to help insure accurate billing to the correct payer. Your card also indicates any co-payments that you may owe for the visit. Please review this information prior to your visit. Lancaster General Hospital will be implementing a document imaging system in the near future that will enable us to place an image of the front and back of your card on your account. If there are any billing issues that arise, we will have your insurance information at our fingertips to help resolve the problems.
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Will you bill my insurance company for me?
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Lancaster General Hospital will bill most insurance plans. Our customers are responsible for submitting claims to any liability insurance companies such as homeowners and school insurance directly. Our Medicare patients are responsible for submitting any co-insurance amount on their professional component to their supplemental carrier unless the carrier receives crossover information from HGSA. If we bill a secondary payer, the customer is responsible for submitting a copy of their explanation of benefits from the primary payer to the secondary payer. The patient will ultimately be held responsible for payment of all services provided, unless Lancaster General Hospital is restricted by a contractual arrangement or federal or state regulations.
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Does Lancaster General Hospital participate with my health plan?
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To "participate" with a health plan, means that Lancaster General Hospital has a contractual agreement with the health plan. It is the customer’s responsibility to contact their health plan to verify that the hospital, physician practice and other healthcare providers participate.
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When am I responsible for obtaining approval from my health plan for the services being provided?
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Your insurance plan may require you to obtain approval from your primary care physician or health plan prior to receiving the services. You should always check with your health insurance carrier prior to the service. If the situation is an emergency, life threatening, you or a family member may contact your physician or health plan within 24 hours of the visit. If the visit is determined to be non-emergent, not life threatening, you may be required to pay for the service yourself.
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Should I pay my co-pay at the time of my visit?
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Why do I have more than one account with Lancaster General Hospital?
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Lancaster General Hospital generates a new number for most services that we provide on different days. Generating a different number for every date of service simplifies the billing process and helps our customer service department help you with your questions regarding different services provided. Lancaster General Hospital does bill certain on-going services such as physical therapy, radiation therapy and occupational therapy with the same account number often for the duration of the service. These accounts bill monthly for all charges entered during that month. An inpatient hospital stay will generally have one number.
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Why do I get more than one bill for the services I received?
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In addition to Lancaster General Hospital’s charges, you may also receive a bill for physician charges such as the emergency room physicians, radiologists that read your x-rays, anesthesiologists, cardiologists etc. These physicians work independently and will bill separately.
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Lancaster General Hospital does not have access to their systems and will not be able to assist you with these bills.
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Why am I receiving a bill for the total amount of my visit when I have insurance?
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Even if the balance is not your responsibility at the time that you receive the blue and white bill, Lancaster General Hospital is required by the Commonwealth of Pennsylvania to provide a copy of services provided to the patient or guarantor.
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Lancaster General Hospital will bill the patient for non-covered services such as the private room difference and guest meals.
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You may receive a bill that indicates that your are responsible for the total amount of the charges for a variety of reasons:
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We may not have your insurance information.
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We may have billed your insurance company and they have not responded to us.
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We may have billed your insurance company and they may have denied the service.
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You should always check the insurance information on the blue and white bill to insure that we are billing correctly.
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When do I become responsible for my bill?
- You are legally responsible for your bill at the time the service is provided. You are ultimately responsible for insuring that the hospital is reimbursed for the services provided to you. Lancaster General Hospital will use the information provided by you to submit your claim for payment. Under Act 68, your insurance company is required to act in your best interests by processing your claim for payment or denial within 45 days of receipt of the bill.
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How do I follow up with my insurance company?
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To prepare for the call with your insurance provider have the following items available:
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Take the name of the person to whom you are talking. Ask the status of the claim. If paid, ask them who the check was made out to, the check number, date of the check and amount. Get the phone number of the person you are talking.
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If the claim has not been paid, ask for the anticipated payment date. Ask if they have all the information to process the claim. If they need additional information, obtain a fax number. The fax number and a contact person are very useful to the hospital.
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Once you have the information you need from the insurance company, contact Lancaster General Hospital’s Customer Service department at (717) 544-4953 or (800) 647-4419 to provide the information you have gathered.
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My explanation of benefits from my insurance company states that I am not responsible for the balance of charges above the usual and customary or reasonable and customary rate. What does this mean?
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Usual and customary or reasonable and customary rates are terms insurance companies use to define what they determine to be the going rate in a particular area. These rates may vary from payer to payer. Lancaster General Hospital does not accept these rates as payment in full. Many charges may vary from one provider to another, some higher and some lower. You will be responsible for the balance of these charges.
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How will I know if my insurance company has paid?
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Your insurance company is responsible for sending you an explanation of benefits regarding any payments they make towards your bill. It should also indicate any liability you have regarding the claim. If you have questions regarding your explanation of benefits, call your insurance company. The explanation of benefits should be kept as a reference tool for any balance due notices you may receive from us.
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If you owe a deductible, co-payment, co-insurance or non-covered charge for a service, Lancaster General Hospital’s billing system will generate a series of letters for the balance due. This is not a detail bill of your account. Refer back to your Blue and White bill cross- referencing the account number to get additional information.
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If your insurance company pays the bill in full, you will not receive any additional bill from Lancaster General Hospital.
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Why am I just now receiving letters for the balance due on services performed quite a while ago?
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What payment options does Lancaster General Hospital offer?
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Lancaster General Hospital accepts cash, money orders, and checks. Credit cards (Visa, Master Card and Discover) and CareCredit
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If you are unable to pay the full balance in one payment, we offer the following terms:
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If the balance is less than $1000.00, the customer can split the payment into a maximum of 6 equal monthly installments.
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If the balance is $1000.00 or higher, a maximum of 12 equal monthly installments.
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Lancaster General Health also offers a Financial Assistance program for uninsured and underinsured patients. This program is based on income, assets and financial need. To discuss your options and obtain a copy of the financial assistance application, please see one of our financial counselors located at the hospital and Suburban Outpatient Pavilion or a contact Patient Financial Services at (717) 544-4953 or (800) 647-4419.
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Lancaster General Health also offers a self pay discount for any medically necessary services provided to any patient without insurance coverage. To receive your discount or to discuss your situation, please contact Patient Financial Services at (717) 544-4953 or (800) 647-4419.
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Why am I receiving letters for an account I already paid?
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Your letter may have been sent just prior to the processing of your payment. The letter may be for a different account. Verify that the account number is the same as the account number of the account that you paid.
If you receive more than one letter after paying an account, please verify that your check was cashed. If it was cashed, ask your bank when it cleared your account. This information will be very helpful to the customer service specialist that will be researching your payment.
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If you do not place an account number on your check and we did not receive the stub from the account with the check, your payment will be posted to the oldest account balance in our billing system. This may not be the account for which you are receiving the letter.
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How can I request an itemization of my account with Lancaster General Hospital?
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How can I pay my balance due?
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You can mail a check, money order, credit card or CareCredit information using the envelope that came with your bill. The mailing address if not using this envelope is Lancaster General Hospital, Attn: Cashiers, PO Box 3555, Lancaster, PA 17604-3555. Be sure to write your account number on your check or money order.
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You can make a credit card payment through our phone system 7 days a week, 24 hours a day by calling (717) 544-4953 or (800) 647-4419. Lancaster General Hospital accepts Visa, Master Card and Discover.
- You can call (717) 544-4953 or (800) 647-4419 and give the credit card information to a customer service specialist. The operating hours for the Customer Service department are 8:30 a.m. to 7 p.m., Monday through Thursday and 8:30 a.m. to 4:30 p.m. on Friday.
- You can pay in person in the financial counselor offices located on the first floor of the Lancaster General Hospital and on the first floor of the Suburban Outpatient Pavilion, 8 a.m. to 4:30 p.m., Monday through Friday.
- You can pay online by filling out our secure form. Pay online
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How can I get additional information?
College of Nursing and Health Sciences
Customer Service
General Information
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Where is the admitting office located?
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What should I bring with me when I am admitted?
- You should bring:
- Pajamas
- Toiletries
- Slippers
- Robe
- Medication List
- You should always carry a current list of medications with you. This is important because you never know when you might need that list of medications. Some prescriptions, vitamins, over the counter medicines or herbal supplements could interfere with other medicines you receive during testing, surgery, or while you are in the hospital. Your doctors and nurses want to keep you safe while you are under their care.
- You will be asked for this list if you have surgery, you are admitted to the hospital, or for some tests or procedures.
- The medicine list should include:
- Prescription medications
- Over The Counter (OTC) medications
- Vitamins
- Herbal supplements
AND include- Dosage or amount of medicine you are taking
- Frequency or how often you take the medicine
- Route or how you take the medicine.
- AND why you are on these medicines
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Do I need money when I am admitted?
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What is the fax number for LGH?
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Can I have a private room?
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Will LGH contact my clergy?
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What are the visiting hours?
- Rest is an important part of the patient's recuperation. Visitors must observe the following regulations:
- Maximum of two visitors at a time.
- Limit visitation time to allow for adequate rest.
- Children must have adult supervision. (Children are restricted from Critical Care areas - 5th & 6th floors)
- Please check with the nursing unit for specific visiting hours, as they vary from unit to unit.
Lancaster General Health Web Site
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How do I get a copy of my medical records?
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You should address your request to Medical Record Services at Lancaster General Hospital.
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You must sign and complete an authorization form to obtain a copy of your medical records.
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You may complete the authorization in one of two ways:
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Come to the Medical Record Services office on the first floor of the hospital, 555 N. Duke St., Lancaster, between the hours of 8:30 a.m. and 5 p.m., Monday through Friday.
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- Medical Record Services
- Lancaster General Hospital
- P.O. Box 3555
- 555 N. Duke Street
- Lancaster, PA 17604-3555
- Fax: 717-544-5914
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How can I get a copy of my own or my child's birth certificate?
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Lancaster General Health is not authorized to provide birth certificates.
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Copies can only be issued by the PA Department of Health, Division of Vital Records. Their website contains details on how to obtain a copy of a birth certificate.
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Lancaster General Health can provide a Certification of Birth, which may meet your needs. To obtain a Certification of Birth, please follow the procedure described above in "How do I get a copy of my medical records?".
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Is there a charge for copying my medical records?
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Lancaster General Health will provide five copied pages free of charge for a patient's personal use. Requests that exceed five pages will be charged at the rate established by the Pennsylvania Department of Health. The charge will not exceed $40.00 for up to 100 pages.
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Medical records sent from Lancaster General Health to another health care provider will be sent free of charge.
Physician Information
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How do I find out information about physicians associated with Lancaster General Health?
- The Find a Doctor link on our Web site has a current database of our medical staff. The database can be quered by last name, group name, city, zip code and specialty or any combination. There is also a Call Me Now feature where a representative will contact you by phone by submitting a form. You can also call our Physician Referral Hotline at 1-888-LGH-INFO (1-888-544-4636)
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Where can I find information on specific ailments and prescriptions?
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Click on the Health Information Library link on our Web site. Here you will find information on a wide variety of health conditions as well as a drug interaction database and articles written by our physicians.
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How do I schedule an appointment?
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Appointment scheduling can be done either by calling our scheduling office at (717) 544-5941 between the hours of 7:30 a.m.-7:30 p.m, Monday through Friday and 8 a.m.-noon on Saturdays. You can also request an Appointment online for certain procedures.
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