Uninsured, Unresolved, and Self Pay Balances

1. Emergent, Urgent, and Labor and Delivery services covered under EMTALA (Emergency MedicalTreatment and Active Labor Act) are not subject to prior payment. Virtua will not engage in any actionsthat discourage individuals from seeking emergency medical care, such as by demanding the emergencydepartment patients pay before receiving treatment for emergency medical conditions or by permittingdebt collection activities in the emergency department or other areas where such activities couldinterfere with the provision of emergency care on a non-discriminatory basis.

2. Payment for known deductibles, copay, and coinsurance amounts are due by the time of service.

3. Payment for non-covered, uninsured and “life-style” services are payable by the time of service (Life styleprocedures are defined as medically unnecessary procedures such as non-restorative cosmetic surgery).

4. Patient balances that cannot be paid prior to service and balances due after insurance payment or denialmust be resolved by one of the following methods:

a. Payment in full from personal funds, credit card;
b. Limited term time payments (see payment arrangement policy); or
c. Approved financial assistance. (See Virtua’s FAP)

- https://webcache.googleusercontent.com/search?q=cache:sQQXa4...
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Note added at 1 hr (2023-02-16 22:51:31 GMT)
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Emergent Services definition

Emergent Services means those resources provided in the event of the sudden onset of a medical, behavioral health or other health condition that the absence of immediate medical attention could reasonably be expected to result in placing the Insured Person's health in serious jeopardy, serious impairment to bodily or mental functions, or serious dysfunction of any body organ or part. - https://www.lawinsider.com/dictionary/emergent-services

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Note added at 1 hr (2023-02-16 22:54:45 GMT)
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Urgent (Urgently Needed Services)

Urgently needed services are covered services that:

Are not emergency services as defined in this section but are medically necessary and immediately required as a result of an unforeseen illness, injury, or condition.

Are provided when the member is temporarily absent from the plan’s service (or, if applicable, continuation) area, or under unusual and extraordinary circumstances, when the member is in the service or continuation area, and the network is temporarily unavailable or inaccessible; and

It was not reasonable given the circumstances to wait to obtain the services through the plan network.

- https://www.uhcprovider.com/content/dam/provider/docs/public... - page 2