FV POLICY
“Cashless Services” & Direct Billing Network
FV Hospital has signed a Direct Billing agreement (also called Third Party Agreement) with several insurance companies so that many services can be provided in a cashless way. If you are covered by an insurance company which is a member of our Direct Billing Network, this means that the hospital will claim to and receive funds directly from your insurance company, bringing you greater convenience and peace of mind.
However, while some insurers in our network cover both outpatient and inpatient services under their Direct Billing policies, many only cover inpatient services; also every policy includes exclusions, deductibles, and limitations of coverage which must be analyzed carefully.
Depending on your policy and on the Direct Billing agreement between FV and your specific insurer, some or all aspects of your treatment at FV may not be covered by your provider and you will be responsible for paying these charges. All of these factors vary from one company and one policy to another, and our insurance officers will be pleased to help you better understand your policy.
Please refer to the end of this brochure for the list of the insurance companies that belong to the Direct Billing Network of FV Hospital.
Inpatient Services
If you are to be admitted to FV Hospital, we will contact your insurance provider before your admission to request a Guarantee of Payment (GOP), which we can usually obtain within four to 48 working hours after sending the required documents to the insurance company or to its administration representative (for example a broker company). However, and particularly in case of emergency admission, we may have to ask you to make a deposit which will then be reimbursed immediately once we have received the GOP.
Usually your insurance company will send us a GOP approving the hospitalisation up to a certain amount and/or a certain duration, with certain exclusions in accordance with your policy. A second GOP may be necessary if your hospitalisation exceeds the amount approved or is longer than expected
If your insurer does not provide a GOP by the time you are to be discharged, you will have pay in full and then claim back the money from your insurer later. FV’s Insurance Office will be happy to guide you through the claim process in this instance.
Outpatient Services
If you are coming for a consultation or for other outpatient services, the billing procedure will depend on the type of card you hold and the scope of services (inpatient or outpatient) for which FVH has signed a Direct Billing agreement with your insurer. Some insurers exclude outpatient services from Direct Billing agreements, some require that the patient co-pays; all have exclusions. Essentially, every policy is different, so read your policy carefully and check with your insurer or contact FVH Insurance Office should you require any clarification prior to consultation.
“Cashless” Services For Other Insurance Companies
Even when FVH has not signed a Third Party Agreement with your insurance company our Insurance Officers will do their best for you to benefit from Cashless inpatient services by liaising with your insurance company or its administration representative. Direct Billing is not possible for outpatient services when your insurance company is not part of FVH Direct Billing Network.
When possible we will request and accept a Guarantee of Payment (GOP) from insurers that are not part of FVH Direct Billing Network. Once the GOP is obtained, which we usually takes 1 to 3 working days, we can provide inpatient services in a cashless way. However, and particularly in case of emergency admission, we may have to ask you to make a deposit which will then be reimbursed immediately once we have received the GOP.
Usually your insurance company will send us a GOP approving the hospitalisation up to a certain amount and/or to a certain duration, with certain exclusions in accordance with your policy. A second GOP may be necessary if your hospitalisation exceeds the amount approved or is longer than expected
We cannot always request for a GOP, for example if the insurance company is based in a distant country with which we have no existing relationship or legal recourse, such as Canada, Russia, Africa, Japan, etc. In such an instance, you will be requested to pay a deposit, and then pay for the treatment costs incurred. You will have to file a claim form with your insurer later and FV’s Insurance Office will be happy to guide and help you through this process.
Non-Cashless Services
If your insurance company is not a member of FVH Direct Billing Network you will be required to pay like any other patient for each service you will receive. The FVH Insurance Officer will be pleased to help you gathering documents required by your insurance company and completing claim forms for you to be reimbursed.
French Social Security (la « sécurité sociale »)
If you are a French resident and are covered under France’s Social Security system, you will have to pay upfront and then submit invoices to your “caisse” in France.
