Online Billing Estimate

If you would like to receive an estimate of your bill prior to care being given, please feel free to contact our billing customer service phone number at 314-525-4747 or toll free at 800-843-6312. The phone lines are open Monday through Friday from 9 to11:30 a.m. and 12:30 to 5 p.m.

We are able to provide the fastest response if you have the following information ready when you call. Feel free to print out this page as a way to gather the information.

You can also e-mail us at patientbilling@samcstl.org.

Request an Online Estimate for Hospital Services

Please complete the following information to submit estimate request. Online estimate requests are processed as soon as possible however some requests may take up to three working days.

Patient Information

Name of Patient:

Date of Birth:
MM/DD/YYYY
Social Security Number:
(optional)
Phone (Call-back purposes):

E-mail Address:

Service Information

Procedure or Service:

CPT Code (from your physician):

Physician ordering service:

Physician office phone:

Physician office contact person:

Insurance Information:

Do you have health insurance:
Yes or No
Type of insurance:

Insurance policy number:

Insurance group number:

Is service scheduled?:
Yes or No
Date (if scheduled):

How We Make Estimates

If you have insurance, you will want to know what your potential responsibility will be after your insurance processes your claim. You will need contact your insurance company to obtain that information.

If you are unsure about some of the information we need, please contact your doctor’s office in order to gather the additional information.

Estimates are based on the information provided by you, your doctor, and your insurance company. Should additional tests be performed or if other services are needed, the estimate will not be valid.

Thank you for choosing St. Anthony’s Medical Center for your health care needs.

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