Billing and Insurance

Operating expenses vary by location because we offer care across Northern California and the Central Coast. As a result, visit and procedure costs may differ between care centers.

If you have new insurance or an updated insurance card, you can submit an update request through My Health Online with these simple steps:

• Visit the Insurance Summary page
• Click the Add a Coverage button
• Follow the prompts
   

You can submit an insurance update request through My Health Online in a few short steps:

• Visit the Insurance Summary page
• Click the Remove button next to the expired insurance
• Follow the prompts
   

When you schedule an appointment, you can authorize a future copay if your clinician offers online payments. We won’t charge your credit card until you check in for your appointment. If you cancel your appointment, we won’t charge your credit card.

Not all clinician practices offer online copay payments, so please check with your care team to learn if your clinician accepts them.

If you have an outstanding account balance, we’ll typically apply your payment to the account. If your account doesn’t have an outstanding balance at the time of the refund, we’ll issue a refund to the original credit card or by check.

It may take over a week to generate, print and mail a paper statement. If you make an online payment during this time, it won’t show on the current statement but will be applied and appear on the next one.

You can pay online using your Visa, MasterCard, Discover or American Express credit card.

You’ll likely have the option to set up a payment plan through My Health Online. To get started, follow these steps:

• Sign in to My Health Online
• To view your account balances, click Open the View / Pay / Print Bill from the menu
• If you have a qualifying balance, click the Set Up Payment Plan button
• The following screens will allow you to select a payment amount, method and date to cover your balance
   

For the most accurate coverage information, please get in touch with your health insurance provider. Their contact details are available on your insurance card. You can also use our Health Plan Search to determine which Sutter hospitals and medical groups accept your health plan.

When you have health insurance, your deductible, allowable amount, copayment (copay) and coinsurance impact the amount you pay for medical services. Because these can vary based on your insurance, use the phone number on the back of your insurance card to contact your health insurance company and learn more. Generally, the main differences are:

• Deductible: This is the amount you must pay for covered healthcare services during a coverage period (typically one year) before your health insurance starts covering its share.
• Allowable amount: This is the maximum amount a health insurance plan will pay for a covered service.
• Copayment (copay): Your copay is the fixed amount for a covered service. You pay this amount before or during your medical service, lab test or prescription.
• Coinsurance: After paying your deductible, this is the percentage of costs you’re responsible for on covered services. Coinsurance represents a cost-sharing arrangement, not an additional insurance plan.
   

See the Statement Walkthrough to answer the following questions:

• What service did I have?
• When did I receive this service?
• Who was the doctor? 
• Where did the service take place?
• Did Sutter send a bill to my insurance company?
• Did my insurance cover the procedure?
• I have insurance, so why am I getting a bill?
   

Facility billing includes charges for services or procedures received in hospitals, inpatient and outpatient centers, or from home health or hospice. These charges may include costs for:

• Administration
• A room
• Equipment
• Labs
• Meals
• Medications
• Nursing
• Technicians
• Therapists
   

Doctor billing includes charges for healthcare services a doctor or other healthcare professional provides, including professional assessment, direction and oversight. These services may be provided at facilities such as a hospital, surgery center or medical office.

When you receive services at a Sutter Health location, a private (non-Sutter Health) doctor sometimes provides your care, including an anesthesiologist, emergency medicine doctor, radiologist, pathologist, or others. These private doctors work at a Sutter Health facility but aren’t employed by Sutter.

We work with insurance companies covering Sutter doctors and private physicians at Sutter Health facilities. However, private doctors are only required to accept some of the insurance plans that the facility does.
 

Your insurance coverage may vary based on what type of services you receive:

• Preventive care is the care you receive to prevent illness or disease, like immunizations, lab tests and screenings. Your annual health exam typically includes preventive care services. 
• Diagnostic care is the care you receive to treat or diagnose a health problem. It includes monitoring current conditions, evaluating new symptoms and conducting diagnostic tests.
• Chronic care addresses health issues or injuries that persist for over 2 weeks, including conditions like congestive heart failure, arthritis or a chronic cough.
   

You can a receive a price estimate several ways:

• For hospital fee estimates, call Sutter Health Patient Advocates at 855-398-1637.
• For doctor fee estimates, call Sutter Health Patient Advocates at 866-961-8566.
• Existing My Health Online (MHO) users can log in to their account for an estimate.

The quickest way to pay your bill is online using My Health Online. You can also pay your bill in the following ways: 

• Mail — Send in a check upon receipt of your bill.
• Phone — Visit Contact Us for the phone number of your local billing agent. 
• In Person — Pay in person at the hospital or doctor’s office where you received services.

Payment options include:

• Check
• Bank bill pay
• Visa, MasterCard, Discover or American Express credit card
• Health Spending Account (HSA) card from Visa, MasterCard, Discover or American Express
   

For details on a specific service, visit My Health Online (MHO) > Billing > Account Details. You can also chat or call the number on your statement to request a detailed bill.

Yes, we’re here to help you cover and ease healthcare costs with financial assistance programs, automatic discounts applied to your account, and payment plans. To learn if you qualify for a payment plan, please contact us at 800-4SUTTER. Eligible people can set up a payment plan for doctor services using their My Health Online (MHO) account or contact the billing office for doctor or hospital services.

Your doctor or healthcare provider assigns a specific code to every medical service. Sometimes, your insurance company may claim the code needs to be corrected and recommend changing it. If this happens, please contact your doctor to verify that the code is accurate.

We base pricing on the services you receive. First, your doctor documents your visit and any procedures. Then, a certified coder assigns the appropriate codes. If you have questions about the coding, please contact your billing office.

To request billing records, use our online chat or call 800-4SUTTER and select the Billing option.