As your health care provider, St. Luke's strives to assist you in understanding the costs associated with your medical treatment. This example will guide you through your billing statement and explain the various sections.

If you have any questions regarding your bill, please contact us.

Numbered areas point out where important information can be found on your billing statement.

1. Area to fill out if paying by credit card
2. Date statement was printed
3. Total portion due payable with this statement
4. Patient’s account number
5. Area to write amount you will be paying at this time
6. Name and address of person recorded as responsible party for account (guarantor)
7. Remit to address
8. Summary of Charges
9. Total balance due by patient
10. Personal or insurance information change notification