Billing & Insurance
All insurance plans have varying requirements, which you must know to ensure coverage. This may require you to take an active role in contacting your insurance plan regarding precertification, referrals, etc. You are encouraged to pay all amounts not covered by insurance at time of preregistration or check-in, including co-pays, noncovered services, deductibles and/or coinsurance.
- Charge information is provided by Revenue Cycle upon request, within a realistic time and at no charge. Your insurance company can give you an estimate of the amount covered. For additional information, contact Financial Clearance at 1-844-372-4497 (toll-free).
- We will request a copy of your insurance card.
- You are responsible for ensuring the requirements of your insurance plan have been met, including precertifications, referrals, etc.
- Insurance claims will be submitted to insurance companies free of charge.
- If you are uninsured or underinsured, a patient advocate from Med Data will work with you to help you find funding for your health care expenses. Call Financial Clearance at 1-844-372-4497 (toll-free).
Remember, insurance policies are a contract between you and your insurance company, and payment of your bill is your responsibility.
How much will the services cost?
We can provide you with an estimate for clinic and hospital charges. An estimate is based on a number of assumptions, such as the services you will receive and the number of days you may be in the hospital. Estimates can vary based on your individual treatment. A fee estimate is compiled by determining the average charges previously billed for the same or similar services and /or procedure(s). We contract with Eau Claire Anesthesiologists for anesthesiology services, which are billed separately. Call 715-834-8721 for estimates on anesthesia costs.
Some factors that may make your total charges higher or lower than average include:
- Recovery time
- Unexpected procedures performed at the same surgical session
- Additional treatments and services
- Ancillary services, such as lab work and X-rays
To request an estimate in Wisconsin, call Financial Clearance at 1-844-372-4497 (toll-free).
Do you take my insurance?
We will bill any medical insurance company with a U.S. address for filing claims. To receive maximum benefits, it is important for you to contact your insurance company to identify providers who are in network for your plan. Insurance typically reimburses more for in-network providers; however, every insurance policy is different. The phone number for your insurance company usually is on the back of your insurance card. If you have benefit or coverage questions, contact your insurance company directly. If you need assistance in contacting your insurance company, please let us know, and we will assist you in facilitating this discussion.
What if I don’t have insurance?
If you do not have insurance, you may be asked to pay a deposit prior to your appointment. We will send you a billing statement following your visit for all charges you owe. Please see the Payments page for additional information.
When can I expect to receive my billing statement?
We submit claims on a daily basis, and insurance companies usually process claims within 25 to 60 days. If you have a patient-responsible balance, you will receive a monthly billing statement indicating your services, any insurance payments and the remaining balance that now is your financial responsibility.
How do I read my statement?
You can find Instructions on the back of the first page of your statement. If you need additional explanation, call the toll-free number on your statement.
Why are there names of providers on my statement that I didn’t see?
There are providers who help with your medical care even though you may not see them. Commonly, these are supervising physicians or physicians who read your lab results, X-rays, EKGs and other tests. You also will receive separate bills from anesthesia and ambulance services if you required those services.
What is an explanation of benefits (EOB)?
An EOB is a detailed document from your insurance company identifying the service, amount paid and the amount that is your responsibility, i.e., copays, deductibles, coinsurance and any other charges your insurance policy may not cover.
Why didn’t my insurance company pay in full?
Charges may be applied to your deductible, copay or coinsurance; charges may not be covered under your benefit plan; coverage was not active at the time of services; or your insurance company may need additional information from you. Please review your EOB for information regarding the amount you owe, and call your insurance company or us if you have any questions or concerns.
Will Medicare cover my entire bill?
Medicare usually pays 80 percent of the allowed amount for covered services after the deductible is met. In addition, Medicare may identify a coinsurance or copayment amount for various hospital services. Please refer to the Medicare brochure available from Patient Account Services.
What if my visit is because I was injured at work?
When you schedule your appointment or check in, please notify us, and we will bill your employer or workers’ compensation for your services. You should notify your employer of the injury, or they may deny your workers’ compensation claim.
Can you bill my auto accident/liability insurance?
There are some instances where we can bill your accident/liability insurance. For more information, call the toll-free number on your statement or present the information when you check in.