Billing FAQs

For services and treatments provided prior to October 1, 2022, patients may receive bills and statements for physician services and from the facility or hospital at which they were treated. Example: A patient who gets chest x-ray will be billed by Emory Clinic for the physician who reads the results/outcome of the x-ray. The hospital will bill for use of equipment and supplies associated with the service.

For services & treatments delivered by an Emory Healthcare physician or at an Emory Healthcare facility on or after October 1, 2022, patients will receive a single bill or statement. There are exceptions:

• Emory Proton Center
• The emergency departments at Emory Saint Joseph's and Emory Decatur hospitals
• Private practice partners in the Emory Healthcare Network, like Peachtree Immediate Care

It is not possible to combine Emory Clinic and Hospital bills or statements for services and treatments provided prior to October 1, 2022, even though we operate under the same Emory Healthcare umbrella. During that time, physician and other professional charges billed by Emory Clinic are maintained on a different system from those used by the Hospitals.

Statements for services or treatments provided on or after October 1, 2022, will be consolidated and can be paid through your MyChart patient portal account.

Services provided by Emory physicians and Emory hospitals can be paid online. Providers that fall under Emory physicians include Emory Specialty Associates (ESA), Saint Joseph’s Medical Group (SJMG), Emory Medical Labs (EML) and the Ambulatory Surgery Center (ASC).

You can make payments for multiple hospital accounts that have a patient balance due. The account number ensures that the payment posts to the correct account.

Visit our Visual Reference Guide for statements and bills to learn more about where you can pay online.

Visit our Visual Reference Guide for statements and bills to learn who you can call for help and where you can pay online.

Visit our Visual Reference Guide for statements and bills to find help on who to call and where to pay online.

If you received care on or after October 1, 2022, payments will appear immediately in your MyChart account. If you are paying for charges on services or treatments provided before October 1, 2022, transactions are posted within two working days of when the payment is made. The new balance will be reflected within 3–5 business days and will also appear on your next scheduled statement if a balance remains on your account.

Emory Healthcare statements can be viewed for up to one year after your date of service. If you received care on or after October 1, 2022, you can see your statements in your MyChart patient portal account. For help with other statements, refer to our Visual Reference Guide on the Online Bill Pay page.

Visit our Visual Reference Guide for statements and bills to learn more about how to pay your bills online.

Emory Healthcare’s customer service department will work with you to establish a mutually acceptable agreement to pay your balance. Visit our Visual Reference Guide on our Online Bill Pay page to find the correct helpline to call.

If you are enrolled in a billing portal, you may update your email and demographic information for receiving your statements.

Please note: Changes made in billing portals outside of your MyChart patient portal account will not update your medical record. However, if you make changes to your personal profile information in your MyChart patient portal account, it will also update the information that appears in your medical record.

Emory Healthcare’s website provides instructions for requesting a copy of your hospital medical record, including a release form to complete. Refer to our Medical Records page. To request a copy of a Clinic or doctor's office record, please contact your physician.

Please refer to the Cost Estimator Tool, powered by MyChart Patient Estimator.

Please refer to the Cost Estimator Tool in MyChart to obtain an estimate of charges for procedures performed in the Emory Healthcare system. If you prefer, you may call us at 404-686-0260 or toll-free at 855-432-3080.

By default, Emory Healthcare sends statements and bills as links in mobile txt and email messages. At any time you can opt out of the email (click unsubscribe) or text (reply STOP) to switch back to paper statements. If you have a MyChart patient portal account, you can update your communication preferences. Choose Communication Preferences in the MyChart menu, navigate to the Billing section, and select that mailbox.

Federal law requires most health insurance plans to cover routine patient care costs* in clinical trials under certain conditions. Such conditions include:

• You must be eligible for the trial
• The trial must be an approved clinical trial
• The trial does not involve out-of-network doctors or hospitals, if out-of-network care is not part of your plan

Also, if you do join an approved clinical trial, most health plans cannot refuse to let you take part or limit your benefits.

Please check with your Health Plan for specific detailed coverage policy.

Health plans are not required to cover the research costs of a clinical trial. Examples of these costs include extra blood tests or scans that are done purely for research purposes. Often, the trial sponsor will cover such costs.

Plans are also not required to cover the costs of out-of-network doctors or hospitals, if the plan does not usually do so. But if your plan does cover out-of-network doctors or hospitals, they are required to cover these costs if you take part in a clinical trial.

Emory Healthcare has a dedicated Clinical Trials Billing Department responsible for evaluating each charge and determines whether the service or item is covered by a trial sponsor. Those services and items that are not covered by the trial sponsor and are routine patient care costs would be included on a claim for third party payer or patient bill.

“Grandfathered” health plans are not required to cover routine patient care costs in clinical trials. These are health plans that existed in March 2010, when the Affordable Care Act became law. But, once such a plan changes in certain ways, such as reducing its benefits or raising its costs, it will no longer be a grandfathered plan. Then, it will be required to follow the federal law.

Federal law also does not require states to cover routine patient care costs in clinical trials through their Medicaid plans.

Medicare

Original Medicare (Part A and/or Part B) pays for routine costs of items and services in certain covered clinical research studies. Examples of these items and services include:

• Room and board for a hospital stay that Medicare would pay for even if you weren’t in a study
• An operation to implant an item that’s being tested
• Treatment of side effects and complications that may occur as a result of the study Original Medicare won’t pay for:
  • The new item or service that the study is testing unless Medicare would cover the item or service even if you weren’t in a study
  • Items and services the study gives for free (many times the treatment will be provided free by the study sponsor)
  • Items or services used only to collect data and not used in your direct health care (like monthly EKGs for a condition that usually requires only a yearly EKG)

If you’re concerned about paying for services Medicare won’t cover, talk to the study staff and see if they can help.

Commercial

Federal law requires most health insurance plans to cover routine patient care costs* in clinical trials. It depends on whether your plan exist before the Affordable Care Act become law in 2010. Please check with your Health Plan for your plan policy.

Yes. If you’re in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan, you can get the same coverage for clinical research studies as a person in Original Medicare, as described in the previous section. If you join certain covered clinical research studies, Medicare will pay for your covered services as if you were in Original Medicare. This means that your Medicare health plan can’t keep you from joining a clinical research study. However, you should tell your plan before you start a study.

• Learn More

Medicare traditional fee-for service reimburses qualifying clinical trial claims on behalf of the Medicare Advantage. Your provider likely has submitted a claim to Medicare Traditional based on the Centers for Medicare and Medicaid Services (CMS) guidelines. CMS waives the Part A and the Part B deductibles, but the EOB may still include the coinsurance or normal member copays for the incurred types of services. Your Medicare Advantage plan very likely may cover the coinsurance or normal member copays after Medicare Traditional process the claims. Please check with your Medicare Advantage plan for your plan policy.

*Routine patient care costs means the costs of any medically necessary health care service for which benefits are provided under a health benefit plan, without regard to whether the enrollee is participating in a clinical trial.