Billing & Insurance

FirstHealth of the Carolinas is committed to providing useful price information for our patients in order to help them make informed health care decisions and better understand health care costs and their out-of-pocket responsibilities. Because hospital billing is complex and insurance coverage is sometimes not clear, the best way to understand your true out-of-pocket costs for health care services is to speak directly with your insurance company or to request an estimate from our team.

Standard Charges

As required by CMS, FirstHealth is providing a comprehensive list of charges for each inpatient and outpatient service or item provided by FirstHealth of the Carolinas. This list is known as a chargemaster. A chargemaster lists charges only and is different than your actual payment. Chargemaster information is not a helpful tool for patients to estimate what they will pay for health care.

Please click on the following links to view FirstHealth’s chargemaster, average charges, discounted cash price and negotiated rates for inpatient and outpatient services.

Updated 4/17/24

FirstHealth Moore Regional Hospital campuses:

Moore Regional Hospital

MRH-Richmond

MRH-Hoke

FirstHealth Montgomery Memorial Hospital

Please keep in mind that the amount listed in the chargemaster is not necessarily the amount a patient will pay for services. Hospitals typically collect much less than the amounts posted on the chargemaster due to discounts negotiated with commercial insurance companies, Medicare, Medicaid and Tricare, as well as discounts that are offered for the uninsured and patients who need financial assistance. We recommend all patients contact their insurer and invite them to speak with a FirstHealth Team Member at (910) 715-6282 to discuss their individual situations and obtain an estimate for upcoming services.

How to Receive a Cost Estimate:

MyChart: You may access cost estimates within your personal MyChart account. Login to your account, select the Billing tab at the top of the page and then click on Estimates. If you don’t have a MyChart account, you may set up an account on the MyChart home page.

300 Shoppable Services: If you do not want a MyChart account, FirstHealth also provides a guest estimate website to help you understand the cost of your care. The link below is a self-service tool that can assist you in estimating the out of pocket costs for 300+ shoppable services, as required by the Centers for Medicare and Medicaid Services (CMS).

Guest Estimate

Review a full list of shoppable services

If you are a Medicare patient, or would prefer to speak to a FirstHealth team member regarding an estimate, please call the number provided below.

• Diagnostic and Imaging Testing: (910) 715-6282
• Surgical Services: (910) 715-1869
• Obstetrics and Deliveries: (910) 715-1869
• Cardiac Catheterization: (910) 715-8564

To receive an estimate for all other services, please call (910) 715-6282. Please have your insurance information available for our specialists. Please keep in mind that this is only an estimate. Actual charges may vary depending on the treatment your physician orders for you.

What is a Chargemaster?

A chargemaster is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital – each test, exam, surgical procedure, room charge, etc. Given the many services provided by hospitals 24 hours a day, seven days a week, a chargemaster contains thousands of services and related charges.

The chargemaster amounts are billed to an insurance company, Medicare, or Medicaid, and those insurers then apply their contracted rates to the services that are billed. In situations where a patient does not have insurance, our hospital has financial assistance policies that apply discounts to the amounts charged.

Health insurance companies contract with hospitals to care for their customers. Hospitals are paid the insurance company’s contract rate, which generally is significantly less than the amount listed on the chargemaster. The insurance company’s contract rate, not the chargemaster, is the basis for determining the patient’s actual out-of-pocket costs. As an example, a hospital may charge $1,000 for a particular service, while the insurer’s contract rate may be $700. If the patient’s insurance plan indicates the patient is responsible for 20 percent of the contract rate, the patient would owe $140 (20 percent of $700).

Billing Questions: If you have questions about your FirstHealth bill, please call (910) 715-1010 or toll free at (800) 798-6946. Monday - Friday 8:30 a.m. - 5 p.m.

Financial Assistance: For more information about our Financial Assistance Policy, please contact Patient Accounts at (910) 715-1010.

Because hospital billing procedures can be confusing; FirstHealth provides professionally trained financial counselors to provide you with information about financial assistance.

Patients who do not have insurance coverage, are unable to provide FirstHealth with adequate insurance information or who wish to file their own insurance claims must pay FirstHealth in full at the time services are provided or make satisfactory arrangements for payment.

Patients with health insurance coverage will be expected to pay any copays, deductibles, co-insurance or any other patient portion at the time services are provided, or make satisfactory arrangements for payment. All requests for payment are estimated amounts due. Any additional amount owed will be billed to you and is due when you receive the bill from FirstHealth.

FirstHealth offers a number of ways to pay your bill:

• Cash
• Check/Money Order
• Debit Cards
• Credit Cards: Visa, MasterCard, Discover and American Express
• Online Bill Payment

FirstHealth has other options that we can discuss with you, such as government-assisted programs and our Financial Aid Program. Assistance is based on financial need, and we will make every attempt to provide you with payment solutions to fit your circumstances. If you have any questions, contact one of our financial counselors at (910) 715-1010.

During your hospital stay, you may receive treatment from physicians and/or other health care providers who will also bill you for their services.

Some of these providers may include:

• Your physician/surgeon or consultant
• Radiologists (physicians who read and review X-rays)
• Anesthesiologists (physicians who administer anesthesia during certain procedures)
• Pathologists (physicians who read and review tissue and lab specimens)
• Emergency physicians (physicians who provide emergency department care/Sandhills Emergency Physicians)

• ACS Consulting (currently for Moore Regional Hospital only)
• Aetna
• America's 1st Choice
• America's Health Plan
• Beech Street
• Benefit Management Service (BMS)
• Blue Cross Blue Shield of NC PPO, Medpoint, POS
• Blue Cross Blue Shield of NC Blue Care, PCP, HMO
• Blue Cross Blue Shield Medicare Advantage
• Cigna Indemnity
• Cigna Perdue
• Cigna PPO/HMO/POS Open Access
• Coresource
• Doctor's Health Plan
• FirstCarolinaCare Insurance Company
• First Health Direct
• First Health Network
• Focus
• GEHA
• Golden Rule
• Great West Life
• Health Advantage Network
• Health Partners
• Healthscope
• Healthsouth
• Humana
• Mailhandlers
• Mamsi
• Medcost
• Medicare (Traditional)
  • FirstMedicare Direct HMO
  • FirstMedicare Direct PPO
  • Medicare Humana PPO
  • Medicare Evercare
• Multiplan
• MVP Healthcare
• National Provider Network/CCN/PPN/Med Advantage
• Nationwide
• N.C. Health Choice
• N.C. Medicaid
• PPO Next
• Primary Physicians Network
• Private Healthcare Systems
• Southcare
• State of N.C. Teachers and State Employees Health Plan
• Tricare
• UHC Silver Compass
• United Healthcare
• Wellpath

Medicaid Managed Care

FirstHealth’s Financial Assistance Program ensures that all eligible individuals can receive medically necessary care at FirstHealth, regardless of their ability to pay. Our financial counselors will work with you to help determine your eligibility. Patients can qualify for up to a 100 percent discount if their adjusted income is at or below 200 percent of the federal poverty guidelines, which are published in the Federal Register. Additional discounts are available on a tiered basis up to 360 percent of federal poverty guidelines. Documentation, such as tax returns and current pay stubs, will be requested to demonstrate financial need.

Any individual that is determined to be eligible for financial assistance under FirstHealth’s Credit and Collections Policy will not be charged more than the amount generally billed by FirstHealth for emergency or other medically necessary care to those individuals that have insurance covering such care. The portion of the bill a financial assistance-eligible individual is personally responsible for paying is the amount after all deductions, discounts and insurance reimbursements have been applied. Services not eligible for financial assistance include Inpatient Chemical Dependency, Outpatient Behavioral Services and Cosmetic procedures.

To apply for Financial Aid, access the financial assistance section within your MyChart account. If you do not have a MyChart account, complete and sign the form below and return to:

FirstHealth of the Carolinas
Attn: Patient Accounts Dept.
P.O. Box 3000
Pinehurst, NC 28374

Financial Aid Application-English

Financial Aid Application-Spanish

FirstHealth will assist you with finding governmental programs that match your current needs. Examples include Medicaid, Vocational Rehabilitation, Crime Victim Assistance, etc.

FirstHealth Payment Plans
FirstHealth offers flexible, interest free payment plans depending on the balance of your account. The payment plan guidelines are as follows:

• Account Balances less than $2000 - the term will be one (1) year and the minimum payment due will be the greater of $50.00 or 1/12th of the patient balance.
• Account Balances $2001 - $5000 - the term may be up to two (2) years and the minimum payment due will be 1/24th of the patient balance.
• Account Balances over $5000 - the term may be up to three (3) years and the minimum payment due will be 1/36th of the account balance.

An initial payment of the greater of 10% of the total account balance or $50.00 is required.

For more information on the FirstHealth Payment Plans, contact Patient Accounts at (910) 715-1010 or toll-free at (800) 798-6946, Monday through Friday, between 8:30 a.m. and 5 p.m.

FirstHealth Patient Account representatives can speak only with the patient or the person designated in writing to receive bills on behalf of the patient. This is required by both federal and state law.

Mosaic Finance Solutions
FirstHealth of the Carolinas has partnered with Mosaic Finance Solutions to offer additional financing options. Mosaic allows you to finance the costs of medical care with affordable monthly payment options for an extended period of time. You can pay the account with convenient monthly installments which will be 2.5 percent of your highest account balance, or a $25 minimum payment, whichever is more.

To get started, complete the Mosaic Finance Solutions consumer credit agreement (consumer credit agreement Spanish version) and return it to:

FirstHealth of the Carolinas
Attn: Patient Accounts Dept.
P.O. Box 3000
Pinehurst, NC 28374

For more information on the MOSAIC Payment Plan, call (910) 715- 1010 or toll-free at (800) 798-6946, Monday through Friday, between 8:30 a.m. and 5 p.m.

Download the Mosaic Finance Solutions Brochure in English and Spanish

FirstHealth Patient Account representatives can speak only with the patient or the person designated in writing to receive bills on behalf of the patient. This is required by both federal and state law.

Discount Program
This program is available to patients without health insurance and insured patients receiving care that is not covered by their insurance plan. A prompt payment discount of 25 percent is available for most services (excluding cosmetic and specially priced self pay programs) when payment is made in full.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out[1]of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Under North Carolina law, a patient cannot be asked to pay more for receiving emergency services from an out-of-network provider than from an in-network provider.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Under North Carolina law, a patient does not have to pay more for seeing an out-of-network provider if no in-network provider was reasonably available.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the federal Department of Health and Human Services at 1-800-985-3059 and/or the North Carolina Department of Insurance at 1-855-408-1212. Visit www.cms.gov/nosurprises for more information about your rights under federal law. Visit www.ncdoi.gov for more information about your rights under North Carolina law.

Cuando recibe atención de emergencia o recibe tratamiento de un proveedor fuera de la red en un centro de cirugía ambulatoria u hospital de la red, usted está protegido contra facturas de sorpresa o facturación por el saldo

¿Qué es “facturación por el saldo” (algunas veces llamado “facturación de sorpresa”)?

Cuando usted visita a un médico u otro proveedor de atención de la salud, podría deber ciertos gastos de bolsillo, como copagos, coseguros y/o un deducible. Podría tener otros costos o tener que pagar toda la factura si visita a un proveedor o institución de atención de la salud que no es parte de la red de su plan de salud.

“Fuera de la red” describe a proveedores e instalaciones que no han firmado un contrato con su plan de salud. Los proveedores fuera de la red podrían tener permitido facturarle la diferencia entre lo que el plan acordó pagar y el monto total cobrado por un servicio. Esto se llama “facturación del saldo”. Este monto es probablemente más que los costos en la red por el mismo servicio y podría no aplicarse a sus límites anuales de gastos de bolsillo.

La “facturación de sorpresa” es una factura inesperada por el saldo. Esto puede ocurrir cuando no puede controlar quién le brinda la atención, como cuando tiene una emergencia o cuando programa una visita a una institución de la red pero es inesperadamente atendido por un proveedor que no pertenece a la red.

Usted está protegido contra la facturación del saldo por:

Servicios de emergencia

Si sufre una condición médica de emergencia y recibe servicios de emergencia de un proveedor o institución fuera de la red, lo más que el proveedor o institución puede facturarle es el monto de participación en el costo de la red del plan (como copagos y coseguros). No pueden facturarle el saldo por estos servicios de emergencia. Esto incluye servicios que podría recibir después de estar en una condición estable, a menos que usted preste su consentimiento por escrito y renuncie a sus protecciones de no recibir facturas por el saldo por estos servicios posteriores a la estabilización.

Según la ley de Carolina del Norte, no se puede pedir a un paciente que pague más por recibir servicios de emergencia de un proveedor fuera de la red que de un proveedor de la red.

Ciertos servicios en un hospital o centro de cirugía ambulatoria de la red

Cuando recibe los servicios de un hospital o centro de cirugía ambulatoria de la red, ciertos proveedores podrían no pertenecer a la red. En estos casos, lo más que estos proveedores pueden facturarle es el monto de participación en el costo de la red de su plan. Esto se aplica a servicios de medicina de emergencia, anestesia, patología, radiología, laboratorio, neonatología, asistentes del cirujano, hospitalista o intensivista. Estos proveedores no pueden facturarle el saldo y no pueden pedirle que renuncie a sus protecciones de no recibir una factura por el saldo.

Si recibe otros servicios en estas instalaciones de la red, los proveedores fuera de la red no pueden facturarle el saldo, a menos que usted brinde su consentimiento por escrito y renuncie a sus protecciones.

Nunca se requiere que usted renuncie a sus protecciones de la facturación del saldo. Tampoco se requiere que reciba la atención fuera de la red. Usted puede elegir un proveedor o instalación de la red de su plan.

Bajo la ley de Carolina del Norte, un paciente no tiene que pagar más por consultar a un proveedor fuera de la red si un proveedor de la red no estaba razonablemente disponible.

Cuando la facturación del saldo no está permitida, también tiene las siguientes protecciones:

Usted es solamente responsable por pagar su parte del costo (como los copagos, coseguros y deducibles que pagaría si el proveedor o la instalación estuviera en la red). Su plan de salud le pagará directamente a los proveedores e instalaciones fuera de la red.

Su plan de salud en general debe:

• Cubrir servicios de emergencia sin requerirle que reciba la aprobación de los servicios con anticipación (autorización previa).
• Cubrir servicios de emergencia de los proveedores fuera de la red.
• Basar lo que usted le debe al proveedor o instalación (participación en el costo) en lo que pagaría a un proveedor o instalación de la red e indicar dicho monto en su explicación de beneficios.
• Contar cualquier monto que usted pague por los servicios de emergencia o servicios fuera de la red hacia su deducible y límite de gastos de bolsillo.

Si piensa que le han facturado equivocadamente, puede contactar al Departamento de Salud y Servicios Humanos del gobierno federal llamando al 1-800-985-3059 y/o al Departamento de Seguros de Carolina del Norte al 1-855-408-1212.

Visite www.cms.gov/nosurprises para obtener más información sobre sus derechos según la ley federal. Visite www.ncdoi.gov para obtener más información sobre sus derechos según la ley de Carolina del Norte.

El contenido de este documento no tiene la fuerza y efecto de la ley y no obliga al público de manera alguna, a menos que sea específicamente incorporado en un contrato. Este documento tiene por objeto ser solamente una aclaración para el público sobre los requerimientos existentes según la ley.

Usted tiene el derecho a recibir un “Estimado de buena fe” que le explique cuánto costará su atención médica.

Según la ley, los proveedores de atención de la salud necesitan entregar a los pacientes que no tienen seguro o que no usan el seguro un estimado de la factura por los servicios y artículos médicos.

• Usted tiene el derecho a recibir un Estimado de buena fe por el costo total esperado de cualquier servicio o artículo que no sea de emergencia. Esto incluye costos relacionados como análisis médicos, medicamentos recetados, equipamiento y honorarios del hospital
• Asegúrese de que su proveedor de la atención médica le entregue un Estimado de buena fe por escrito, por lo menos un (1) día hábil antes de su servicio o artículo médico. También puede pedirle a su proveedor de la atención médica y a cualquier otro proveedor que elija, un Estimado de buena fe antes de programar un servicio o artículo
• Si recibe una factura que es por lo menos $400 más que su Estimado de buena fe, usted puede disputar la factura.
• Asegúrese de guardar una copia o imagen de su Estimado de buena fe.

Para preguntas o más información sobre su derecho a un Estimado de buena fe, visite www.cms. gov/nosurprises o llame al 1-800-985-3059.