Insurance
At the time of registration, you will be asked to provide either your current insurance company card or information about your current insurance company. In addition, please furnish any specific forms or original documentation (claim forms, authorizations, referrals, etc.) required by your insurance company.
MercyOne will bill your insurance carrier if you have provided us with all necessary policy information. In the absence of necessary billing information, you will be responsible for payment of your entire account.
During the registration process, you will be asked to sign an Assignment of Insurance Benefits form. This form allows MercyOne to file your medical claim with your insurance carrier and have your carrier make payments directly to MercyOne. Please read this form carefully. The registration staff will be happy to answer any questions regarding its content.
MercyOne files your insurance claim as a courtesy service. However, you are ultimately responsible for paying for the services provided.
Pre-certification
Many insurance plans have pre-certification requirements. Generally, you or your physician is responsible for obtaining pre-certification. Most insurance companies will not accept pre-certifications from the hospital.
To avoid penalties or reduction of payments, for which you will be responsible, call your insurance carrier or employer for specific information.
Non-Covered Services
Insurance companies do not pay for all medical services, even those that might be helpful to a patient. When a service is not covered by your insurance policy, you are responsible for paying the bill.
Physicians dictate your diagnosis for each visit or procedure. We are unable to change this information just so the claim will be paid.
Medicare
During registration, Medicare recipients being admitted into the hospital will be presented with the form, “An Important Message from Medicare.” This form provides important information and telephone numbers that may be needed by our Medicare patients.
Medicaid
We require all Medicaid patients to present a current eligibility card at the time of registration. Without verification of your coverage, you will be responsible for your account.
We will bill your account to Medicaid when all necessary information has been provided. You are responsible for non-covered portions and spend-down requirements associated with your individual coverage.
Third Party Liability
If you have been injured in some manner, whether through an automobile accident, fall, etc., MercyOne will bill your health insurance first, then the liability carrier you specify for any deductible or co-payments your health insurance did not pay.
Although another party may have some legal responsibility for your injuries, this matter is between you, your attorney and the party responsible for the injury.
If you are a Medicare or Medicaid recipient, health care laws require that we bill the liability carrier first, then Medicare or Medicaid.
Fee Reductions
Our fees are accepted by most insurance plans as “usual, customary and reasonable.” We do not make UCR reductions unless we have a contractual arrangement with your insurance company.
Claim Payment
Most insurance companies routinely audit some of their claims. If your insurance company selects your claim for audit, you may experience a delay in your claim being paid.
MercyOne will provide your insurance company with any detailed information they might need to complete their audit. However, Mercy has no control on the length of time the insurance company takes to complete the audit.
In the event that your insurance carrier is not prompt in making payments, MercyOne will need your assistance in contacting your carrier for payment. Insurance carriers are more responsive to patient inquires than to ours.
No Insurance
For our hospital patients without insurance who meet income guidelines, MercyOne offers a discount off our total billed charges. An application for the discount is required.
Discounted charges are not available for patients who have insurance coverage (such as Medicare, Medicaid, Health Savings Accounts, Health Reimbursement Accounts, Commercial or Private Insurance policies) or applicable to patients who qualify for MercyOne's financial assistance program. Discounts are not applicable to patients' co-payments or deductibles from their insurance policies.
When health services are completed, you will receive a summary of charges. If you will have difficulty paying the amount in full, please contact us.
