What does my payment have to be to keep my account out of collections?
All self-pay balances are billed to you in full. You will receive two billing
statements followed by two collection letters. If the account is not paid in full
or a payment plan established by this time, the charges will be submitted to a collection
agency. If you cannot pay the bill in full you should contact our Central Business Office
(CBO) at 806-761-0334 when you receive your statement to set up a budget payment plan.
Only a plan which we have mutually agreed to will keep your account from going to collections.
Do you take my insurance?
UMC Physicians physicians participate in most PPO plans but you are encouraged to contact your insurer to
verify if the physician you would like to see is included on the list of in network providers
for your insurance. If you see a physician that is not in-network with your insurance, you risk
reduced benefits or no coverage at all if you see that physician and you will be held responsible
for what your insurance does not pay.
Who is SBI and why are they contacting me?
SBI (Service Bureau Incorporated), is the outside collection agency that UMC Physicians uses when self pay
balances are not paid within an acceptable timeframe and we are unsuccessful collecting the balance
within our in-house collection process. If you receive a letter or a phone call from SBI, you need
to contact them to settle on the account. If you have specific questions about the charges, you can
contact the CBO or the physician's office.
How can I get a copy of my medical records?
You must sign a release in order for UMC Physicians to give you your medical records or to send them to another
physician. You need to contact the physician's office to request a release of medical records form.
They will have you sign the release and give you a copy of your records. There are no medical records
kept at the CBO.
I do not have any insurance, can I still get a discount?
If your account is in good standing your physician can elect to give you a discount for payment in full.
Contact the CBO and we will contact your physician and see if the physician's office is able to discount
the services.
What is a co-pay?
A co-pay is the money that your insurance requires you to pay for medical services you receive. Usually
there are different co-pays for different services. An example of a common co-pay is $25 for every
physician office visit. Your insurance will be responsible for the remaining balance of the charge.
Some insurance companies have co-pays on laboratory and x-ray services, prescriptions, procedures, etc.
Every insurance company is different so you should be able to refer to your plan documents and/or your
insurance card to see what your co-pays are for different services.
What is a deductible?
Your insurance company often has a deductible either on particular services, or on your medical services
altogether. A deductible is an amount that your insurance company has determined that you are responsible
to pay to the provider. Once you have met your deductible your insurance company will kick in and start
paying based on your benefits. A deductible on your car insurance works the same way.
My spouse and I both cover our children under our insurance, which one is responsible
to pay as primary?
To determine which insurance is primary and which insurance is secondary you need to look at both you and
your spouse's birth-dates, (with no regard to the year), and whichever falls first in the calendar year
is primary and the other insurance is secondary. This is referred to as the birthday rule.
For example, if you were born July, 16th and your spouse on August 8th, your insurance would be primary.
Why am I being billed in full when I gave my insurance information to the physician's
office staff when I was there?
The answer could be as simple as the charge was actually keyed into the computer system prior to updating
the insurance information. This is certainly not intentional and if you do receive a statement showing you
owe the full amount and there is no notation on the statement letting you know the charges are being denied
by your insurance, you can contact the CBO with your insurance information to direct the charges correctly.
Why when I receive my explanation of benefits from my insurance, does it reflect
a physician I did not see?
Most insurance companies identify a physician by their Tax Identification number. Since many physicians in
a group use the same Tax Identification number, often the insurance prints the name of the first physician
listed in their system associated with that number. More often than not they have them listed in alphabetical
order so if you see Dr. Stevens and your explanation of benefits reflects Dr. Brown that is most likely what
happened. The insurance also keeps track of the physician you actually saw. If you have any concerns, please
contact the CBO and we will answer any questions.
Why was my claim processed this way?
Claims are processed by your insurance company and UMC Physicians follows their instructions based on your policy. If you
believe that your insurance company has processed your claim incorrectly, please contact your insurance company
or contact the CBO if you have other questions.
Why does my bill show that Medicare applied these charges to my deductible but
my deductible has already been met?
Medicare has a deductible each year. Medicare determined that these charges should be applied to the deductible.
Many times it is because there could be services you had prior to these that you believe covered your deductible,
but Medicare has not processed them yet or the physician billed them late. If this is the case, those charges that
haven't been processed yet, when billed, will be paid and not applied to your deductible. Medicare will not apply
more towards your deductible, however, they may not process the charges in the same order you expect. You should
call Medicare to find out why they put these charges to your deductible if you think it was in error.
Why does my statement show only Medicare when I have a supplemental insurance
company?
Our statements only reflect your primary insurance. You will see in the detail area of the statement any transactions
that have occurred due to your supplemental insurance company. If you are being billed and do not see any evidence of
your supplemental insurance processing the claim, please contact our office and we will be happy to verify the
insurance we have on file.
Where is the payment I made, it doesn't show on my statement?
Our statements only include open charges. If your payment paid one or more of your charges in full, those charges and
that payment will not appear on the statement any longer. Only balances still due will show on your statement as well
as the payments associated with them. If you want to verify that your payment was received and has been posted to your
account, you can contact our office and we will be happy to assist you.