Patients & Visitors

Common Billing Question

Can I make an appointment to talk to someone about my bill?

A financial representative is located in Main Admitting (in the tower lobby). Walk-ins are welcome, but if you would like to schedule an appointment, please call 281.401.7632.

We also have patient account representatives that can handle your questions over the phone. Patient Account Representatives are assigned to specific insurance carriers. If you have questions regarding your bill, please contact the appropriate patient account representative.

Insurance Company	Patient Acct. Rep.	Telephone #
Aetna	Cathy	281.401.7639
BCBS Members	Rhonda	281.401.7643
BCBS TRS	Rhonda	281.401.7643
Beech Street	Edna	281.401.7640
Blue Cross Blue Shield (except Members)	Rhonda	281.401.7641
Cigna	Linda	281.401.7027
Humana	Cathy	281.401.7639
Humana Medicare HMO	Cathy	281.401.7639
Medicaid all plans (Amerigroup, all CHIPs,)	Marie	281.401.7027
Medicare (except Medicare HMOs)	Linda	281.401.7643
Medicare HMO plans (Texas Health Springs)	Marie	281.401.7027
Montgomery County Hospital District	Marie	281.401.7027
Montgomery ISD	Marie	281.401.7027
PHCS (Private Healthcare Systems)	Linda	281.401.7882
Tower Life–TRMC Employees	Linda	281.401.7882
Unicare	Edna	281.401.7640
United Healthcare	Rowena	281.401.7642
Waller County	Marie	281.401.7027
Workers Comp (all plans)	Cathy	281.401.7639
All Others Not Listed Above	Edna	281.401.7640

What are my payment options?

Reference your patient account number on all payments and inquiries. Contact the appropriate account representative listed above to pay by phone or make payment arrangements. We accept cash, check, and credit cards (MasterCard, Discover, Visa and American Express).

There are 3 payment options currently available…

Make a payment by phone with a check or credit card, or
Click to Pay your Hospital Bill Online with a credit card, or
Mail payment to:
Tomball Regional Medical Center
PO Box 1797
Tomball, Texas 77377

What health plans does Tomball Regional Medical Center accept?

Click to view the accepted Contracted Health Plans. The information on this list is subject to change at any time without notice. Please contact your health plan to confirm a facility's continued participation in your particular network.

Why do I get so many bills for my hospital visit?

Many hospital services are contracted through outside agencies such as, Radiology, Anesthesiology, and Pathology. These companies will send a bill and/or statement directly to your residence for services rendered during your hospitalization.

The physician that attended to your visit is not an employee of Tomball Regional Medical Center and will also be sending you a separate billing statement. Contact your physician's office, IPA or medical group regarding these charges.

Anesthesiology Bayou Anesthesia & Pain 17207 Kuykendahl, Suite #200 Spring, TX 77379 Telephone: (832) 698-5331 Fax: (832) 698-5321	Pathology Tejas Pathology PO Box 1568 Tomball, TX 77377-1568 Telephone: 281.357.4409
Emergency Medicine Tomball Regional Emergency Physicians Associates (TREPA) 9229 LBJ Freeway Dallas, TX 75243 Telephone: (972) 739-3710 Fax: (972) 739-2632	Radiology Houston Northwest Radiology Associates 810 Peakwood, Suite #107 Houston, TX 77090 Telephone: (281) 440-5158 Fax: (281) 440-8549

What is the difference between HMO, PPO and POS?

HMO stands for Health Maintenance Organization. An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals. An HMO patient must select a Primary Care Physician (PCP) contracted with their HMO. The patient’s PCP is responsible for referring the patient to any and all additional providers (specialty care physicians, hospital, etc). HMO plans have no out-of-network reimbursement and patients who seek care from non-contracted providers will have no coverage.

PPO stands for Preferred Provider Organization. PPO coverage encourages patient selection of a PCP, however, it is not mandatory since PPO plans allow patients direct access to all network physicians. PPO plans normally provide coverage for out-of-network providers, but the patients out-of-pocket for non-participating providers will be considerably higher than in-network care.

POS stands for Point of Service. POS plans are a combination of PPO and HMO philosophy. POS patients can access all network providers. If they access specialty care physicians through a PCP referral they normally have an HMO lower type of co-payment. If they access specialty care directly, without a PCP referral, there is normally a deductible and higher out-of-pocket expense. The point a patient accesses service will dictate the level of benefits payable.

If I have an HMO policy, can I be billed if they do not pay?

If you have an HMO policy, you should only be billed for the amount specified on your explanation of benefits (EOB) that your insurance carrier provides to you. This usually includes co-pay amounts. However, the patient is responsible for all non-covered services and services denied due to failure to follow program requirements.

If you are unsure if a service is covered, or if you have questions regarding referrals and how to properly access hospital care based upon your HMO guidelines please contact your insurance carrier.

What is a co-payment?

A co-payment specific dollar amount due each time a patient receives care. Most plans have different co-payments due per visit based upon the provider. Primary Care Physicians co-payments are normally less then Specialty Care Physicians, with ER, and other types of care subject to their own co-payments. The cost is usually minimal and a patient should be aware of their co-payment amounts based upon their ID card or benefits booklet.

What is a deductible?

Deductibles are usually a standard amount that the patient has to pay before insurance benefits are provided. For example, if a member's policy contains a $500 deductible, the member must accumulate and pay $500 out of pocket before the insurance carrier will pay benefits. Once the patient has met their deductible, the carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are yearly, usually starting in January.

What is co-insurance?

Co-insurance is a percentage % the patient will owe (usually 10% or 20%) of the contract allowable amount for the care rendered. Co-insurance normally applies to all care, emergency room, hospital admissions, office visits, etc. Healthcare Providers can estimate a patient’s responsibility; however, until the claim is paid we can only estimate the contractual allowable and patient responsibility.

What is supplemental insurance?

Supplemental insurance is additional insurance purchased to cover charges not paid by a primary payer. There are many Supplemental Plans available and coverage varies greatly between the various plans. It’s very important a patient understand what their supplement will pay as even with two or more plans you may be responsible for a portion of the bill.

What is preauthorization, and who is responsible for taking care of it?

Most insurance plans have a list of tests, procedures, admissions, etc., that require patient or provider notification before the service is rendered. Failure to obtain pre-authorization may result in the claim being denied or only partially paid. As a courtesy to the patient the hospital completes preauthorization. However, the patient is ultimately responsible to ensure all insurance carrier requirements are met for the insurance carrier to cover services.

What if I didn’t give anyone my insurance information at the time of service?

Call the hospital immediately at 281.401.7632 to speak with a Patient Account Representative.

Who is responsible for paying my bill?

The hospital will bill your insurance company directly as a courtesy to the patient. You are ultimately responsible for making certain that your bill is paid. If a balance remains after your insurance has issued a payment or a denial, payment is due within two weeks.

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