FAQ: General Billing
FAQ: General Billing
General Billing Questions
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.
Yes! Your insurance card contains information we need to file a claim with your insurance on your behalf. You will be expected to provide complete and accurate insurance information at every visit. Your registration process goes much faster when you bring your insurance information with you.
If you have provided your insurance information, we will bill your services 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 you provided accurate and complete insurance information when you registered and we participate with your insurance, you will not receive a bill until the following has occurred:
Your insurance company denies your claim;
Your insurance company pays the claim, leaving a copay, coinsurance, deductible, or non-covered amount as your responsibility;
Your insurance company hasn’t responded to the claim in a timely manner.
If we do not participate with your insurance, you are responsible for making payment at the time of service.
You are legally responsible for your bill at the time you receive services from the provider. We require all patient balances be paid upon receipt of your first statement, or you contact our Business Office Payment Center to make acceptable payment arrangements.
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.
Please contact our Business Office Payment Center at (855) 494-7968 and speak with our patient accounts representatives, to correct any error that may have occurred.
If it has been at least 60 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 our Business Office Payment Center at (855) 494-7968 and a customer service representative will assist you.
Payment for your portion of the bill (co-insurance, co-payment, deductible, non-covered services) is due within 30 days of receiving a bill. Payment can be sent by check, money order, or paid on-line with any accepted credit cards. Please do not send cash through the mail. If you choose to pay in cash, please pay in person at the Patient Access Department. Please include the patient’s name, account number and date of services with your payment.
Our Patient Financial Representatives are available and here to assist you. Please contact our Financial Counselor’s Office at 517.663.9477 to discuss options that might be available to you.
Please contact our Business Office Payment Center at (855) 494-7968 to discuss payment arrangements or our Financial Counselor at 517.663.9477 to inquire about financial assistance.
For more information on acquiring insurance, visit www.enrollmichigan.com and www.healthcare.gov.
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.
For more information on acquiring insurance, visit www.enrollmichigan.com and www.healthcare.gov.
We ask that payments are made when you are registering for your services 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.
For more information on acquiring insurance, visit www.enrollmichigan.com and www.healthcare.gov.
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.
For more information on acquiring insurance, visit www.enrollmichigan.com and www.healthcare.gov.
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.
You may pay your bill in person in the Patient Access Department, located in the main lobby of Eaton Rapids Medical Center. The office is open Monday through Friday from 8:00am-5:30pm. Payments can be made with cash, check, money order or most credit cards.
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 Health Information Management Department. A fee may be required. For further questions, contact Health Information Management at (517) 663-9421.
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.