Billing Information

Insurance Coverage and Payment

You may have questions about your financial responsibility and exactly what your insurance may cover. Below are the most common questions patients ask about their insurance coverage and answers to those questions.  By giving you a summary of your financial rights and responsibilities, we hope you can concentrate on the most important part of your hospital stay… getting better.

Billing and Payment: Frequently Asked Questions

General FAQ’s

Do I need to let my insurance company know that I am in the hospital?

Many changes have taken place in the health insurance industry in recent years. Procedures and services once covered in full are now only partially covered, covered only under certain circumstances, or in some cases not covered at all.

Since every insurance plan is different, please be sure to check your coverage and ask questions. You can contact your insurance plan directly, or contact your employer for more information.

Your insurance plan can deny payment for services or procedures even after the service has been completed. Many health maintenance organizations (HMOs) and insurance plans now require pre-admission notification, approval or second opinions for certain procedures.

For your own peace of mind, we recommend you know the benefits of your individual plan. If you don’t follow your insurance company’s rules it could mean more expense for you. 

 

Q. Does the hospital need a copy of my insurance card?

Yes. Your insurance card contains information we need to file a claim with your insurance on your behalf. Your registration process goes much faster when you bring your insurance information with you.

 

Q. How does the Billing Process work?

If you have provided your insurance information, we will bill your services claims with your insurance company. 

If you provide us information on a secondary carrier upon receipt of payment from your first carrier, we will bill your secondary insurance as well.

You should receive an explanation of benefits (EOB) from your insurance company explaining what was paid. We find that insurance companies usually mail the explanation of benefits to you one or two weeks prior to sending Eaton Rapids Medical Center the check. 

If payment is not received in a timely fashion from your insurance carrier, we will request your assistance in contacting your insurance carrier for payment.

If we do not have a contract with your insurance, you will need to pay for services within 30 days of your first statement. As a courtesy, we will then submit your claim to your insurance company  for reimbursement to you.

 

Q. When will I receive a bill?

If you verified your insurance information when you registered and we participate with your insurance, you will not receive a bill until:

• Your insurance company denies your claim;
• Your insurance company pays the claim, leaving a coinsurance, deductible, or non-covered services;
• Your insurance company hasn’t responded to the claim.

If we do not participate with your insurance, you are responsible for making payment at the time of service.

Q. When do I become responsible for paying my bill?

You are legally responsible for your bill at the time you receive services from the provider. We require all patient balances be paid immediately after you are notified.

 

Q. It has been months since my date of service and I am only now receiving a bill.

Some insurance plans take up to 90 days or longer to pay a claim. If we participate with your insurance, during this time we do not send out information to our patient’s regarding their billing activity, as we have found this action often leads to some confusion. Upon receipt of payment from your insurance carrier, you will receive a bill from Eaton Rapids Medical Center for any remaining balance, which includes details of your insurance payment activity and other useful information.

 

Q. What if I find an error on my bill?

Please contact our Billing Office at 517.663.9407 and speak with our patient accounts representative, to correct any error that may have occured.

 

Q. How can I check on my account?

 If it has been at least 45 days since the date of service, contact your insurance carrier about your  claim. After speaking with your insurance carrier, if you still have questions regarding the claim, contact Patient Accounts at 517.663.9407 and a customer service representative will assist you.

 

Q. How do I pay my bill?

Payment for your portion of the bill (co-insurance, co-payment, deductible, uncovered services, full bill) is due prior to leaving the hospital or within 30 days of receiving a bill. Payment can be sent by check, money order, or accepted credit cards. Please do not send cash through the mail. If you choose to pay in cash, please pay in person at the Registration Department. Please include the patient’s name, and account number with your payment.

 

Q. What if I am having difficulties paying my co-payment or deductible?

Our Patient Financial Representatives are available and here to assist you. Please contact the  Billing Office at 517.663.9407 or Financial Counselor’s Office at 517.663.9477 to discuss options that might be available to you.

In some circumstances a Care Payment Plan may be established.  The Care Payment Plan will be set up for the amount of your account when the plan is established. After the plan is approved, any new charges are not included.  If you need to have them included, you must call our Patient Accounts Representative at 517.663.9407 to have new charges added to existing payment plan. Bills are mailed monthly from your Care Payment Plan network.

 

Q. What if I do not have insurance?

Please contact the Patient Accounts representative at 517.663.9407 or Patient Financial Representatives in the Registration Department at 517.663.9477 to discuss payment arrangements with you.

 

Q. The doctor, nurse, or business representative told me that the charge(s) for my service(s) would be a certain amount and I am being billed a different amount. Why?

Clinical or business personnel are normally able to provide only an estimate of the cost of services in advance of care. Also, they are not always able to predict what other ancillary or professional services your doctor may order. We do our best to provide accurate estimates of cost, but the final bill may be different from the original estimate.

 

Q. Why are you asking for my deductibles, co-insurances, or co-payments at the time of my visit?

We ask that payments are made when you are at the registration office so you won’t be bothered with an invoice sent to your home after your visit. It also helps us reduce our costs and saves you the trouble of mailing a payment back to Eaton Rapids Medical Center.

 

Q. How do I know if my insurance company will cover my visit/services?

Coverage varies with each insurance company. We encourage you to check with your insurance company or your employer about this. Generally, our providers do not know whether a particular service will be covered. Medically necessary and appropriate services may not always be covered by your insurance contract. Please refer to your insurance member handbook or call your insurance company with questions.

 

Q. What part of the balance am I responsible for when my insurance doesn’t cover services?

If there is a balance that was not covered or paid by your insurance, or secondary insurances, then you are responsible for the balance as soon as you receive a bill.

 

Q. Where can I pay my bill in-person? Can I pay my bill in cash?

You may pay bills in person in the Registration Department, located in the the main lobby of Eaton Rapids Medical Center. The office is open Monday through Friday from 8:00am-8:30pm. Payments can be made with cash, check, money order or most credit cards.

 

Q. I received a letter from my insurance company asking me about a visit to Eaton Rapids Medical Center. It is asking me whether my visit was related to an accident. I have not been involved in an accident, what should I do?

Medical treatment related to an accident is often covered by auto insurance or worker’s compensation insurance. Your health insurance plan simply needs to know if your medical expenses should be billed to another insurance company. Please answer the questions appropriately and mail the questionnaire back to your insurance company. If you do not respond, your claim will be denied and you may be responsible for payment.

 

Q. I was injured at work and I thought my employer would pay the bill?

This could be true. However, in order to bill your claim, we need the complete name, address, city, state, and telephone number of your company’s Worker’s Compensation insurance carrier, and a claim number. Then, please contact us, and as a courtesy, we will bill your Worker’s Compensation insurance carrier. If you told the Emergency Department staff that this was a worker’s compensation injury, you will be provided with the appropriate form. This form needs to be completed by your employer, and returned to ERMC Patient Registration. Until this is returned, you will be responsible for the balance.

Q. My child is a college student and is on my insurance policy. Why can’t I know why he/she was in the hospital?

Because your son or daughter is a legal adult, we are obligated under HIPAA (Health Insurance Portability & Accountability Act) to protect the privacy of your son or daughter.  You may request a Release of Information form from Eaton Rapids Medical Center at 517.663.9421.  You must obtain consent and a signature from your adult son or daughter, along with a witness signature to release the records to yourself and forward that form to the Medical Records Department.  A fee may be required.  For further questions, contact Medical Records at 517.663.9421. 

We thank you for choosing Eaton Rapids Medical Center as your medical care provider.

 

Patient Accounts

Eaton Rapids Medical Center

1500 S. Main Street

Eaton Rapids, MI  48827

517.663.9200