Billing FAQ

When your child is in the Hospital or seeing a specialist, you should focus on helping him or her get better. We understand that medical bills can be a concern and we’d like to help by providing information and answers to the questions that we hear most often regarding billing.

What should I do if I think there’s a mistake on my bill?

Please contact the Phoenix Children’s customer service line at 1-800-549-3743.

What is a deductible?

A deductible is the amount of money you must pay before your insurance company begins covering part or all of your medical expenses. Check your insurance coverage details to confirm the amount of your deductible. Deductibles may apply to any hospital service, including hospital stays, Specialty and Urgent Care, or Outpatient visit performed at Phoenix Children's affiliated locations.

What is co-insurance?

After you meet your deductible, co-insurance is a set percentage of the insured medical expenses you may be required to pay. Check your insurance coverage details to confirm your co-insurance percentage.

What is a co-payment?

This is a set payment you make every time you receive a medical service, according to your insurance coverage. Check your insurance coverage details to confirm the amount of your co-payment, which is due when you receive services.

Can I get an estimate of what services will cost before my visit?

Yes, our Pre-Access Department can provide an estimate of the cost of medical services in advance. If you receive treatment in the Emergency Department, our Financial Counseling Department can provide this information for nonscheduled services.

Why are some of my hospital bills covered by insurance and some are not?

Hospital coverage often has a deductible or out-of-pocket expense you are responsible for paying before full coverage applies. Because each insurance plan is different, please review your benefits carefully and contact your insurance company if you have questions about coverage or eligible expenses.

If my child spends the night in the Hospital, will I be charged as an inpatient?

At times your physician may determine the need to evaluate your child’s condition or determine the need for possible admission to the Hospital as an inpatient. Although your child may be staying in the Hospital overnight, he/she is an outpatient of the hospital. As a patient in Observation Status, your insurance will pay on an outpatient basis and you may be responsible for any out of pocket expenses such as co-payments and deductibles, in accordance with your specific insurance plan. If at a later time your physician determines that your child should be admitted to the hospital as an inpatient, we will notify you of this change from outpatient to inpatient status.

Why did I get multiple bills for my child’s hospital stay?

In order to comply with Centers for Medicare and Medicaid Services and insurance industry regulations, Phoenix Children’s bills for both facility and professional services. So when you visit Phoenix Children’s or one of our clinic sites you may receive more than one bill. The bill you receive from Phoenix Children’s is for use of our facility (facility charges). The bill you receive from Phoenix Children's Medical Group (PCMG) is for the physicians, radiologists and other specialists employed by Phoenix Children's. Other clinicians may bill you separately from their own practices (professional fees). We all work together to provide excellent care for your child.

What is a facility charge?

A facility charge covers the cost of running the facility (hospital or clinic). This includes supplies, equipment, exam rooms and non-physician staff. The facility charge varies based on whether your child is a new or established patient, the type of visit, and the hospital resources required to effectively treat your child.

Why is there a facility charge for clinic visits?

Phoenix Children’s Specialty Clinics are licensed by the state of Arizona as Hospital-based Clinics. Thus they incur the same facility charge as a visit to the main campus. This is a standard practice for most other hospital-based clinics across the country. 

Will my insurance cover the facility charge?

This varies by insurance carrier. Some insurance companies cover the entire charge; others cover a percentage. It’s best to check first with your insurance company on their coverage of hospital-based clinic facility charges so you will know what to expect.

What is a professional fee?

This is the bill from the doctor(s) who treated your child. When your doctor works directly for Phoenix Children's, the bill will come from Phoenix Children’s Medical Group (PCMG). However, we have many doctors on our Medical Staff, who meet our rigorous requirements for training and experience, but are not employed by Phoenix Children’s. You will receive a bill directly from their practice for their professional fees. Depending upon the complexity of your child’s condition and the services provided, you may receive bills from multiple physicians.

What is an outpatient surgery center and why would I have a procedure done there versus at a hospital?

An outpatient surgery center is a location outside of a hospital main campus operating room where surgeons can provide services for their patients. Based on the complexity of the procedure required and the patient’s medical status, the doctor will make a determination on the location for the surgery. Sometimes it can be less expensive when a procedure is done in an outpatient surgery center than in a hospital operating room. The cost would depend on the length of the procedure, the materials used, the type and time of anesthesia, recovery time etc.

What if my doctor asks another doctor to visit my hospital room while I’m there? Will I be charged for that?

Primary care doctors often ask another doctor to stop by and visit a patient for a consult while in the hospital. If a doctor orders a specialty consult or any additional services, parents can refuse to have the service, although we would expect that the doctor explained the rationale or need for which the consult or extra service (e.g., therapy, radiology, lab) was ordered.  You could potentially receive two bills for this type of additional service; one from Phoenix Children’s and one from Phoenix Children’s Medical Group (PCMG) or an outside physician practice for the individual physician’s time.

Who should I call if I have questions about a bill I’ve received?

If you have questions about your bill, please contact the specific provider at the number listed on their billing statement.

Can I pay my bill online?

Yes, Phoenix Children’s offers online bill pay.