Insurance

As a courtesy to our patients, Shore Memorial Hospital will bill your insurance carrier for services rendered. Any physician related billing is handled by your physician’s office. Shore Memorial Hospital participates with the following carriers and networks.

Shore Memorial Participates With The Following Carriers:

AETNA — ALL HMO, MEDICARE HMO, INDEMNITY, PPO, EPO and POS PRODUCT LINES

AMERIHEALTH — ALL HMO, MEDICARE HMO, PPO AND INDEMNITY PRODUCT LINES

ATLANTICARE — PPO PRODUCT LINE

BEECH STREET/MEDICHOICE — PPO PRODUCT LINE

CIGNA — HMO AND PPO PRODUCT LINE

FIRST HEALTH — PPO PRODUCT LINE

FIRST MANAGED CARE OPTION — PPO PRODUCT LINE

HEALTH CARE PAYERS COALITION OF NJ — PPO PRODUCT LINES

HEALTHNET (formerly known as PHS - PHYSICIAN HEALTH SERVICES) — TRADITIONAL HMO PRODUCT LINE

HORIZON BLUE CROSS — ALL HMO, MEDICARE HMO, PPO, INDEMNITY, NO FAULT AND WORKER'S COMP PRODUCT LINES

INDEPENDENCE BLUE CROSS (IBC) — PPO PRODUCT

MANAGED CARE, INC. — PPO PRODUCT

MEDICAID — TRADITIONAL PLAN

MEDICAID - MANAGED CARE HMO — HEALTHNET, UNIVERSITY HEALTH PLAN, AMERIGROUP/AMERICAID and HORIZON NJ HEALTH. (If you are a participant in any other Medicaid HMO Product please contact the Member Service area to make sure you are able to have services rendered at SMH)

MEDICARE — TRADITIONAL PLAN

MULTIPLAN — PPO PRODUCT

NYLCARE/SANUS — HMO PRODUCT

OXFORD - HMO PRODUCT LINE

PHP OF NJ (PHYSICIAN HEALTH PLAN) — PPO PRODUCT

PHC (PRINCIPAL HEALTH CARE) DELAWARE — HMO AND PPO PRODUCT LINE

QUALCARE — HMO PRODUCT LINE

SIMCARE/MEDIPLEX — PPO PRODUCT

TRICARE

UNIVERSITY HEALTH PLANS — MEDICAID PRODUCT ONLY

UNITED HEALTHCARE — PPO and INDEMNITY PRODUCT LINES

COMMUNITY CARE NETWORK

CONSUMER HEALTH NETWORK

DEVON HEALTH SERVICES, INC.

INTERGROUP

PHCS (PRIVATE HEALTHCARE SYSTEMS)

PREMIER PREFERRED CARE

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SHORE MEMORIAL WILL ALSO ASSIST YOU WITH THE BILLING OF YOUR INSURANCE CLAIMS RELATED TO YOUR AUTOMOBILE OR WORK RELATED INJURIES.

We hope this information has been of help to you. PLEASE KEEP IN MIND, regardless of the type of insurance plan you have YOU MUST COMPLY WITH YOUR CARRIER’S REQUIREMENTS. PLEASE BE AWARE, if your plan uses a Primary Care Physician (PCP) to direct your medical services then you must obtain the necessary REFERRALS AND/OR PRE-CERTS. ADDITIONALLY, WHILE SHORE MEMORIAL HOSPITAL MAY BE CONSIDERED A PARTICIPATING PROVIDER (PAR) WITH YOUR CARRIER IT IS POSSIBLE THAT YOUR PHYSICIAN IS NOT A PARTICIPANT IN YOUR PLAN. PLEASE MAKE SURE TO CALL YOUR INSURANCE CARRIER TO CONFIRM WHETHER OR NOT A PARTICULAR PROVIDER IS A PARTICIPANT IN YOUR PLAN. This also applies to any service provided by an anesthesiologist, cardiologist, pathologist or radiologist.

Lastly, if you are eligible for Medicare and have signed up for an HMO (THAT TAKES THE PLACE OF YOUR TRADITIONAL MEDICARE) we need to know this at the time you schedule and/or register for your service(s). Please advise the person taking your insurance information of all possible coverage. This allows our staff to make sure the proper carriers are being billed in the correct order and this will ensure the accurate processing of your claim.

The Patient Accounting Department Staff is here to assist you with any questions that you may have regarding your insurance coverage.

SHOULD YOU WISH TO DISCUSS A BILLING MATTER FEEL FREE TO CALL THE FOLLOWING NUMBERS:

If you have questions about —

INPATIENT MEDICARE CLAIMS, please call: 609/653-3717, ext.4012

OUTPATIENT MEDICARE CLAIMS, please call: 609/653-3717, ext. 4014

MEDICAID CLAIMS, please call: 609/653-3717, ext. 4023

HORIZON/AMERIHEALTH CLAIMS, please call: 609/653-3717, ext. 4011

DIALYSIS CLAIMS, please call: 609/653-3717, ext. 4010

WORKER’S COMP CLAIMS, please call: 609/653-3717, ext. 4027

NO-FAULT(AUTO) CLAIMS, please call: 609/653-3717, ext. 4028

COMMERCIAL CLAIMS, please call: 609/653-3717, ext. 4021

SHOULD YOU WISH TO DISCUSS PAYMENT ARRANGEMENTS FOR A BALANCE YOU OWE, IF YOU WISH TO SEE IF YOU QUALIFY FOR CHARITY CARE OR YOU WANT TO CHECK THE STATUS OF A CHARITY CARE APPLICATION, PLEASE CALL THE FOLLOWING PHONE NUMBERS IN OUR CREDIT/COLLECTION AREA:

PATIENT BALANCES AND CHARITY CARE INFORMATION
FOR LAST NAMES A — F,
Please Call: 609/653-3717, ext.4018

PATIENT BALANCE AND CHARITY CARE INFORMATION
FOR LAST NAMES G — O ,
Please Call: 609/653-3717, ext. 4020

PATIENT BALANCE AND CHARITY CARE INFORMATION
FOR LAST NAMES P — Z ,
Please Call: 609/653-3804

PATIENT BALANCE AFTER MEDICARE ,
Please Call: 609/653-3717, ext. 4020

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