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 have to pay 33% of your balance to keep the
charges from going to our in-house collection agency. If you cannot make a payment of at least 33%,
you should contact our office when you receive your statement to set up a budget plan that is affordable
to you and sufficient enough to 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 verify if the physician you would
like to see is included on the list of in network providers for your insurance. If you arrive at the clinic
and are unsure, you should inquire with the staff prior to seeing the physician. 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 you went to.
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 that you need the records from. 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 standings your physician can elect to give you a discount. 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 for. 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.
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 information and we will
get it taken care of.
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, this is only happening
when they are choosing who to send the explanation of benefits to. If you have any concerns however, please contact the CBO and we will
answer any questions you might have.
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 of $110. Medicare must have determined that these charges should be applied to the deductible. You should
call Medicare to find out why they put these charges to your deductible if you think it was in error. Many times it is because there could be
services you had prior to these that you believe covered your deductible, but for some reason 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 than $110 towards your deductible, however, they may not process the charges in the same order you expect.
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 more than 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 your bank to see if the payment has cleared or you can contact our office and
we will be happy to assist you.