Billing at MCMH + Clinics
Our approach to patient billing and collections is positive and proactive, with the goal of receiving payment for services rendered in the most efficient, timely, and customer-oriented manner possible. We understand that navigating medical expenses can be confusing, which is why we offer comprehensive billing services to assist you in meeting your financial obligations for payment of your medical services.
We take pride in our commitment to transparency and pricing fairness, and we provide pricing information for our services on a publicly available database. If you require financial assistance, our Federal Poverty Guidelines-based program offers support to those in need.
Admissions / Registration
We will verify your personal information and ask to make a copy of your insurance cards every time you visit, so that we may be assured we have complete information billing Medicare, Medicaid, or your health insurance. We will also ask you to sign a Consent for Treatment, Release of Information, and an Assignment of Benefits. At the time of registration, we ask that you pay any co-pays or deductibles designated by your insurance plan. If your insurance plan requires notification or pre-authorization prior to obtaining services, please bring any documentation verifying this has been done.
Billing FAQ's Glossary of Terms:
Deductible:
The amount that must be paid out-of-pocket before the insurance company will pay for medical services.
Co-insurance:
After deductibles and co-pays are met by the patient, the insurance pays a percentage of the covered charges, such as 80%. The 20% that is the patient's responsibility is the coinsurance.
Co-payment:
The amount payable by the patient towards each visit to the doctor or emergency room. Some plans may require co-pay for each outpatient hospital visit as well.
Contractual Adjustment:
Sometimes seen as a network discount or Provider's responsibility. This amount is based on our contract with the insurance company.
EOB:
Explanation of Benefits. This is a notice sent to the insured from the insurance company explaining how a claim was processed.
Out-of-Pocket:
The amount paid by the patient for medical services. This generally (but not always) refers to deductible and coinsurance. Co-pay is not considered to be part of the Out of Pocket.
Out-of-Pocket Maximum:
When the patient's deductible plus the amount paid for coinsurance meets the plan's out-of-pocket threshold. In general, further covered services are payable at 100% for the remainder of the benefit period. Some plans may have provisions whereby particular services are never payable at 100%.
Emergency Services:
Emergency services will never be delayed or withheld on the basis of a patient's ability to pay.
