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Sample Bill

Indicate address corrections below.

1234 S. CARTER
ABILENE, TEXAS 79602-11234

***You may pay online here.

Hendrick Medical Center
P.O. Box 3117
Abilene, TX 79604

Business Office located at:
2182 Hickory
325-670-2437 or 1-800-670-0412

Acct #
Number assigned to the guarantor, which will always remain the same

Due Date
Date your payment is due, if you owe a balance

Pay This Amount
The patient portion due for all visits listed on this statement

Guarantor Name and Address
Name and address of the guarantor held responsible for all hospital visits listed on the statement, multiple patient names may appear

Date of Service
Reflects the date the medical service(s) were provided

Reflects the patient seen, visit number and type of service provided

Total charges posted to visit

Total Adjustments
Reflects any adjustments posted to the visit including any insurance contractual adjustments

Total Insurance Payments
Reflects any and all insurance payments posted to the visit

Pending Insurance
An estimate of the expected payment from your insurance company

Total Patient Payments
Reflects all personal payments made on the visit

Patient Balance
Reflects the amount you owe for the visit

Statement Date
Date the statement was printed

Patient Payments Since Last Statement
Reflects any personal payment you have made since your last statement was printed

Current Pending Insurance
Reflects any and all pending insurance payments on any visit listed on this statement

Current Patient Balance
Reflects the patient portion of all listed visits on this statement

Pending Insurance is an estimate of the amount we expect to be reimbursed by the insurance company based on the information we have. How the insurance actually reimburses has a direct effect on the patient portion. Once we have a response from the insurance company, either in the form of a payment or denial, we move the outstanding amount from the Pending Insurance to Patient Balance. The guarantor becomes responsible for the balance once insurance has paid or denied.