Patient Billing Information
At Children's of Alabama (COA), we understand taking care of your child along with accumulating medical bills can create a stressful situation. Focusing on providing great care for your child should remain your first priority, so we hope the following billing resources will help guide you through the medical billing process.
Children's of Alabama knows that it is helpful for patients and families to have pricing for services and procedures to guide them as they make informed healthcare decisions.
A Children's staff member is available to answer questions related to pricing:
Monday-Friday: 9:00a.m.- 4:00p.m.
Phone Number: 205-638-5600.
Thank you for choosing Children's of Alabama to provide healthcare for your child.
Online Bill Payment (for date of service prior to March 4, 2023)
MyChart - Children's of Alabama (for date of service after March 3, 2023)
Can I get an estimate of my health care costs?
What do I do if I received a bill for $400 or more than my Good Faith Estimate?
How can I view a list of Children's of Alabama standard charges?
What are the 300 Shoppable Services at Children’s of Alabama?
What should I do if I have a question about the cost of the service or procedure my child will have at COA?
What should I do before I bring my child to Children's Hospital of Alabama?
What if I do not have any health insurance and my child is not covered?
When I pay my co-pay at my child's clinic visit, what does that cover?
What financial forms will I need to sign when I bring my child to COA?
If my child receives inpatient or outpatient psychiatric treatment or mental health services--will the hospital, psychologists, and psychiatrists providing services at Children's of Alabama be included in my insurance network?
Will I receive a separate bill for the care my child will be provided by a CRNA?
Is my insurance billed?
Why did I receive more than one bill?
How do I pay my bill?
When I make a payment, how is the money applied?
What is covered in the surgery estimate provided to me?
Why was my account sent to bad debt/collections?
I'm having trouble with my child's medical bills. Can you help me set-up a payment plan?
How do I request an itemized statement?
How can I view a list of Children's of Alabama standard charges?
You have the right to request and receive a good faith estimate explaining how much your health care will cost. Good faith estimates can be requested through our Financial Counselors at 205-638-2722 or emailing GFE@childrensal.org. A good faith estimate includes any item or service reasonably expected to be provided in conjunction with a scheduled item or service like medical tests, drugs, equipment, and hospital and professional fees. If you request a good faith estimate before you schedule an item or service, a good faith estimate will be provided to you in writing within three business days after your request.
Under the law, health care providers are required to give certain qualifying patients an estimate of their bill for healthcare items and services before those items and services are provided, whether requested or not. A qualified patient is an uninsured individual who does not have benefits for an item or service under a group health plan, group or individual health insurance coverage, a federal healthcare program or an individual who has benefits for such item or service but he does not want a claim for services submitted to their plan and have indicated such. If you schedule healthcare services at least three business days in advance, and are a qualifying patient, a good faith estimate will be provided to you in writing within one business day after scheduling. If you schedule healthcare services at least 10 business days in advance, and are a qualifying patient, a good faith estimate will be provided to you in writing within three business days after scheduling. If you schedule healthcare services less than three business days in advance, an estimate is not guaranteed but we will attempt to satisfy all requests.
A good faith estimate will be provided in your requested language using your preferred delivery method (US mail, email or fax). Make sure to save a copy or picture of your Good Faith Estimate.
The good faith estimate shows the cost of items and services that are reasonably expected for your healthcare needs for that item or service. The estimate is based on information known at the time the estimate was created. The good faith estimate does not include any unknown or unexpected cost that may arise during treatment including additional tests or interventions ordered by your caregiver. You could be charged more if complications or special circumstances occur.
If you receive a bill with an expected payment that is at least $400 or more than your good faith estimate, you can dispute the bill. The dispute process is described with your Good Faith Estimate and can be found in these FAQs.
What do I do if I received a bill for $400 or more than my Good Faith Estimate?(Back to Top)
If you were billed for more than the good faith estimate you received, you may have the right to dispute the bill. First, contact us at GFE@childrensal.org to let us know the billed amount was $400 or more than the good faith estimate. We will determine the differences and explain the cause for the higher amounts. If you understand the differences and agree, you may pay the bill, set up a payment arrangement or see if you qualify for financial assistance.
If you disagree with the higher amount due, you may also start a dispute resolution process with the US Department of Health and Human services (HHS). If you choose to use the dispute resolution process you must start the dispute process within 120 calendar days of the date on the original bill. There is a $25 fee to use the dispute process. To learn more and get a form to start the process, go to www.cms.gov/nosurprises/consumers. If the selected dispute resolution entity agrees with you, you will have to pay the quoted cost on the good faith estimate, reduced by the $25 fee. If the selected dispute resolution entity disagrees with you, you will have to pay the higher amount billed. If you dispute your bill, we will not move the disputed bill into collections or threaten to do so. If the disputed bill has already moved to collections, we will stop collection efforts. You will not receive any further collection activity on the disputed unpaid bill after the dispute resolution process has concluded. There is no negative action against you for disputing your bill.
How can I view a list of Children's of Alabama standard charges?(Back to Top)
Children’s of Alabama is required by Centers for Medicare and Medicaid Services to provide a complete list of gross charges, insurance negotiated rates and cash prices. There is an additional requirement to provide a list of 300 shoppable services. View a list of these charges and rates as of December 1, 2022. To better understand the information presented: “Gross charge” is the amount billed on the claim for each service provided. “Negotiated Rate” is listed by insurance and is the expected payment amount. Each item has been individually priced but depending on the care you receive or the care setting, items may be bundled together on the claim. Physician services are not included in this list. Most physicians are not directly employed by Children’s of Alabama and as such their services will be billed separately from their billing offices.
The following information may be helpful based on your health coverage. Please note the hospital charges may not help you determine your out of pocket costs.
Blue Cross of Alabama (and most Blue Cross Plans)
All inpatient services are bundled together and paid as one daily rate based on your status at midnight. The daily rate is reflected in the list of standard charges. (Daily rate X number of days admitted = negotiated rate for inpatient stay).
Outpatient services are paid on a unique methodology. Children’s of Alabama negotiates an outpatient base rate which is applied to each service (Base rate for 2022 is $1,675.11). Each outpatient service is individually weighted using a proprietary system utilized by Blue Cross. The negotiated rate is multiplied with the service weight to determine the negotiated rate. (Base rate X service weight = negotiated rate). In most cases, if there is more than one billable service, multiple charges may be bundled with other services or considered as payment as part of another service.
Transplant services are paid on an all-inclusive rate depending on the type of transplant provided. The all-inclusive rate covers all inpatient services and certain outpatient services for a limited time period pre- and post-transplant.
These factors make determining a negotiated reimbursement rate and out of pocket costs difficult in many instances. For questions about your particular case, please contact a Financial Counselor or your insurance company directly.
Other Commercial Plans (Aetna, Cigna, Viva, United HealthCare)
Both inpatient and outpatient services are paid based on negotiated discount off gross charges. Those discounted rates are reflected in the list of standard charges.
Children’s of Alabama offers a cash price for scheduled services only. Cash prices must be determined prior to services rendered. To take advantage of the cash price, payment must be made in full prior to services being rendered. Children’s of Alabama does not bill the patient’s insurance when the cash price is applied. Please contact a financial counselor to discuss your particular case.
What are the 300 Shoppable Services at Children’s of Alabama? (Back to Top)
CMS requires that Children’s of Alabama provide rates for certain defined and most commonly provided services. Each shoppable service listed includes all of the charges routinely incurred during the delivery of such services for Children’s of Alabama patients. This is intended to be an estimate, as your exact charges may be more or less depending upon your specific needs. For questions about your particular case, please contact a Financial Counselor or your insurance company directly.
What should I do if I have a question about the cost of the service or procedure my child will have at COA? (Back to Top)
Children's of Alabama knows that it is helpful for patients and families to have pricing for services and procedures to guide them as they make informed healthcare decisions. A Children's staff member is available to answer questions related to pricing Monday-Friday from 9:00a.m. - 4:00p.m. The phone number is: 205-638-5600.
What should I do before I bring my child to Children's Hospital of Alabama? (Back to Top)
Review your insurance plan, particularly the hospital-based outpatient coverage. All COA clinics (including downtown clinics, Children's on 3rd, and Children's South at Acton Road) operate as hospital-based outpatient clinics.
Understand any co-pays, deductibles, and co-insurance you may owe for your child's care. Depending on your health plan, you may pay more for certain outpatient procedures or services. Health insurance coverage greatly ranges from plan to plan.
- Co-pay is a fixed amount of money to be paid at the time of service that is set forth by your health insurance plan.
- Deductible is the amount of money you are required to pay before your insurance company covers medical care costs. **With the trend to higher deductible plans, it is more costly on the frontend for medical bills, as you will pay / be responsible for all of your deductible (for any services) before your insurance company will begin paying for the services.
- Co-insurance is the set percentage of insured medical costs that you may be responsible for once you pay your deductible.
What if I do not have any health insurance and my child is not covered? (Back to Top)
Please call our Financial Counselors at 205-638-2722 before your child's visit. You / your family may be eligible for financial assistance. Children's of Alabama is committed to providing healthcare to each child in need, regardless of the family's ability to pay.
When I pay my co-pay at my child's clinic visit, what does that cover? (Back to Top)
The co-pay you make at the clinic is for the physician / surgeon (professional) fee. There may be a separate hospital / facility fee charged that you will be billed for later.
What financial forms will I need to sign when I bring my child to COA? (Back to Top)
The Acknowledgement of Hospital Outpatient Services Billing: This form explains that when you bring your child to any COA specialty / outpatient clinic (at downtown location, Children's on 3rd, or Children's South at Acton Road), your child receives care in a hospital-based outpatient setting. Carefully review your insurance plan to find out what insurance will cover and if any out-of-pocket expenses will be required.
The Clinic Financial Consent: This form explains that you will be responsible for any medical expenses that are not covered by your insurance plan.
If my child receives inpatient or outpatient psychiatric treatment or mental health services--will the hospital, psychologists, and psychiatrists providing services at Children's of Alabama be included in my insurance network? (Back to Top)
Your health insurance company may have a separate network for the hospitals and physicians (professional fees) who provide mental health care for your child. Please contact your health insurance company to find out if there is a separate mental health network. There are plans in which Children's Hospital is in-network for medical services but out-of-network for mental health services. In addition, the psychologists and psychiatrists who provide mental health services may be out-of-network while the hospital is in-network. You should always contact your health insurance company to ask about the coverage for each of these: hospital services, psychiatrist services and psychologist services.
Will I receive a separate bill for the care my child will be provided by a CRNA? (Back to Top)
Under certain health insurance coverage, Certified Registered Nurse Anesthetists (CRNAs) bill separately for the services they render. Please be sure to check your health plan to understand the coverage of anesthesia services (used in surgeries and procedures) your child may receive.
Is my insurance billed? (Back to Top)
Yes, COA bills your insurance company based on the information you provide. This is why it is important to supply the most up-to-date, complete insurance information. Be sure to bring your current health insurance card with you to Children's of Alabama.
Your insurance company should send you an Explanation of Benefits (EOB) outlining total charges, payments, and any co-pays or deductibles you owe.
Please contact a customer service representative with your insurance company if you have questions about how much they paid or why they denied a claim.
Why did I receive more than one bill? (Back to Top)
For all inpatient stays, your hospital bill includes charges for hospital / facility fees only. Several other professional and physician services are provided at COA to allow for high-quality and integrated patient care.
For all hospital-based outpatient clinic visits (Children's downtown, Children's South, and Children's on 3rd), each of the following services performed at Children's of Alabama is billed separately, in addition to the COA facility bill. They include but are not limited to: laboratory, surgery, radiology, anesthesiology, pathology, ENT physicians, ER physicians, neonatology, cardiology, pulmonary function testing, nutrition, speech therapy, physical therapy, occupational therapy, psychiatry, psychology evaluations, and all other diagnostic or therapeutic services.
For multi-specialist clinic visits (where your child may see more than one physician or therapist in the same clinic), each specialist, therapist, etc. who treats your child will bill separately. Some of the multi-specialist clinics at COA include: Cleft Palate, Muscular Dystrophy Association (MDA) Clinic, Spina Bifida Program, and Weight Management Program.
How do I pay my bill? (Back to Top)
There are three ways for you to pay your child's medical bill. They are:
If you had a date of service prior to March 4, 2023 and would like to pay your bill go here:
- Online Bill Pay (https://payment.childrensal.org/COA)—can be used for Children's Hospital of Alabama inpatient and outpatient services, Children's Behavioral Health professional fees, and ENT professional fees.
- Call to speak with a Children's billing customer service representative at: 205-638-5600. Hours of operation are: Monday-Friday: 9:00 a.m.-4:00 p.m.
- Mail-in a money order, check or credit card information—for all other types of bills. In the upper left corner of the bill, you will find the billing entity's address and contact numbers. When mailing in the payment, be sure to include the billing stub with your child's name and account information to insure your payment is applied correctly.
If your date of service is after March 2, 2023, please go to MyChart and follow registration instructions:
When I make a payment, how is the money applied? (Back to Top)
Our standard procedure is to first apply the money paid to your child's oldest unpaid account (for any service / medical care received at COA) unless you bring a specific bill with you to pay.
What is covered in the surgery estimate provided to me? (Back to Top)
The surgery fee includes the surgery and the post-operation appointment (surgeon's professional fee only). If at the post-operation appointment, the surgeon orders any tests and/or additional procedures (such as lab work, CT scan, MRI, X-ray, etc.) for your child—these services will be billed separately.
Why was my account sent to bad debt/collections? (Back to Top)
You will receive three bills before your account is turned over to a collection agency. A phone call typically accompanies the bills to further alert you. After 120 days, if you make no attempt to pay—your account will be sent to a collection agency.
I'm having trouble with my child's medical bills. Can you help me set-up a payment plan? (Back to Top)
Children's of Alabama is committed to providing healthcare to each child in need, regardless of the family's ability to pay.
Yes, we offer payment plans, financial assistance, and discounted care rates.
Please call 205-638-5600 or 844-750-8950 to speak with a customer service representative who can discuss financial assistance options with you for your child's COA hospital or clinic visit facility fee. You can also visit www.childrensal.org/financial-assistance for additional information.
Please utilize the link below to access a Billing Customer Service Contact List for other professional billing entities' numbers to discuss separate payment options for these services.