Allina Health

Coverage varies with each insurance company. So please refer to your insurance member handbook or call your insurance company with questions about what's covered.

Generally, clinic staff members do not know whether a service will be covered. Your insurance plan may not always cover medically necessary and appropriate services.

You should pay your co-pay or co-payment at the time of service. The amount is determined by your insurance plan.

At the time of your visit, you can pay in full with cash, check, or by credit card (Visa, MasterCard, American Express or Discover).

If you cannot pay at the time of your visit, we can send you a bill for the medical services you received. After receiving your bill, you can send in a check or credit card payment. You can also pay your clinic bill online at allinahealth.org/payclinicbill.

These programs can help you arrange monthly payments:

• MedCredit Financial Services offers a financing option for your medical expenses at an 8% APR or .67% per month. Advantages of opening a MedCredit account include immediate financial approval, no credit application, no annual fees or dues, and convenient monthly payments. Applications are available in your clinic. For more information, call MedCredit at 612-585-8444 or 1-800-755-0965.
• Partners Care was developed to ensure that everyone has access to health care services. This program is available to established Allina Health patients and their family members who meet certain financial guidelines. You may ask your clinic representative for a brochure and application or call 612-262-9000 or 1-800-859-5077.

Learn more about our financial assistance services.

If you verified your insurance information when you registered, you will not receive a bill until your insurance company has…

• denied the claim
• paid the claim and there is a co-insurance, deductible, or non-covered service for which you are responsible
• not responded to the claim
• determined your coverage is not valid or cannot be verified for the date the services were provided

Payment of your bill is ultimately your responsibility and due upon receipt of your first statement.

Each service a patient receives during an office visit has an American Medical Association code associated with it.

• CPT (current procedural terminology) codes identify the services performed and the reason they were performed.
• ICD-9 (international classification of diseases) codes specify the diagnosis associated with your visit.

The billing statement for your visit includes these codes. They inform your insurer of the services provided and why they were provided.

Federal law requires appropriate, accurate coding. Coding must reflect what happens during your medical visit and match what is recorded in your medical record.

When denied coverage, people sometimes are told that they would have been reimbursed for a specific procedure if another code had been used. But it's illegal to change codes just to obtain reimbursement. That's why it's important to understand your coverage so that you will not be surprised if a service is not covered.

Yes. To make sure we have the right billing information, we will ask to see your insurance card at every visit. We also will ask you to verify your name, address, Social Security number and employer.

If your claim is for a work-related injury or motor vehicle accident, you will need to provide the necessary information to bill the liability insurer. To comply with government guidelines, we will ask you to sign a form verifying this information.

If insurance information is not available or not provided to us, the account will be billed directly to you.

Please remember that you are ultimately responsible for the charges on your account for treatment you received. Allina Medical Clinic will not become involved in liability disputes.

Preventive care is important to you and your doctor for your continued good health.

Preventive services or screenings may detect an undiagnosed disease, even if you do not have any signs or symptoms. Preventive services typically happen during an annual or wellness exam. They may include a complete physical exam, immunization advice, routine laboratory tests or X-rays, or guidance on diet, exercise, smoking cessation or other health issues.

Coverage for preventive services varies among insurers. To determine your coverage, check your health insurance policy and contact your insurance company with any questions.

Medicare may pay for certain cancer screening tests, as well as diabetes monitoring and self-management. For more details, visit the preventive services section of Medicare's Web site.

We are concerned that you receive the care you need, regardless of insurance coverage.

If your doctor orders tests or services that may not be covered, you may be asked to sign an advance beneficiary notice (ABN). By reading and signing this form, you agree to pay for the service if your insurance company denies coverage.

Because your health care is your doctor's primary concern, your doctor will be happy to address any additional concerns.

If the doctor needs to provide additional treatment or information about your additional concern, you may receive an additional charge. Here's why: Insurance carriers require accurate reporting from doctors when preventive care and additional problems are addressed during the same visit. So while you may be taking care of two health care concerns at one time, your insurer may see it as taking care of two office visits in one and assess your benefits accordingly.

Because there are so many types of insurance plans, we usually cannot tell you whether you need prior approval or notification for your hospital stay. That's why we encourage you to contact your insurance company or your employer with questions about what is or is not covered by your insurance plan.

Yes. The hospital needs information on your insurance card to file a claim with your insurance company.

When you register, we will ask for information about your insurance coverage and have you sign a few forms. This process goes much faster when you bring your insurance information with you.

Yes. As a one-time courtesy we will bill your insurance company. It is your responsibility to provide insurance information requested (explanation of benefits, claim forms, accident information) in order to make this happen.

If you have more than one insurance plan, you need to provide a copy of the explanation of benefits to the second insurance. For example, if you're on Medicare in addition to another health plan, you should send an explanation of your Medicare benefits to the other health plan. (For more about Medicare billing, see our Medicare questions and answers.)

After your insurance company has paid its portion of your hospital bill, we will send you a statement of account. This statement indicates the amount that has been paid and any balance you are required to pay. You have 30 days to pay any balance indicated on the statement of account.

When you call your insurance company about a claim, be sure to do the following:

• Have available your insurance card, date of service, facility name, original billed amount, patient name and claim number if applicable.
  
• If the bill has been paid, ask when and to whom. Note this information and whom you talked to at the insurance company
• If the bill has not been paid, find out when the anticipated time frame of payment is, and ask if they need anything from you. (You may need to contact the clinic or the hospital's medical records department.
• If thebill isn't paid in the stated time frame, call the insurance company again and, if necessary, ask to speak with a supervisor.

You will not receive a bill until after your health insurance company has paid or denied the claim related to your care. If you gave us insurance information when you registered, the first bill you will receive will indicate what your insurance has paid and what your balance is after all insurance payments.

At the time of your visit, you can pay in full with cash, check, or by credit card (Visa, MasterCard, American Express or Discover).

If you cannot pay at the time of your visit, we can send you a bill for the medical services you received. After receiving your bill, you can send in a check or credit card payment. You can also pay your clinic bill online at allinahealth.org/payclinicbill.

These programs can help you arrange monthly payments:

• MedCredit Financial Services offers a financing option for your medical expenses at an 8% APR or .67% per month. Advantages of opening a MedCredit account include immediate financial approval, no credit application, no annual fees or dues, and convenient monthly payments. Applications are available in your clinic. For more information, call MedCredit at 612-585-8444 or 1-800-755-0965.
• Partners Care was developed to ensure that everyone has access to health care services. This program is available to established Allina Health patients and their family members who meet certain financial guidelines. You may ask your clinic representative for a brochure and application or call 612-262-9000 or 1-800-859-5077.

Learn more about our financial assistance services.

You are legally responsible for you bill at the time you receive services from the hospital. We require all patient balances to be paid within 30 days after you are notified that you have a balance.