More Information
Insurance
Once services are provided, the billing team at ValleyCare Medical Group of Ohio will submit your claim directly to your insurance carrier. We will work with your insurance to resolve any questions they have during the processing of the claim. If information is needed from the patient to further process the claim a statement will be sent to the patient to notify of the balance due and to contact the insurance carrier to resolve.
Secondary Insurance
Claims are filed to the patient's secondary insurance if one was provided.
Medicare Non-Covered Services
Medicare will not pay for services that are considered not medically necessary. Prior to a service being rendered the physician office is to identify if the service is considered not medically necessary and present an Advanced Beneficiary Notice of Non-Coverage (ABN) form to the patient that notifies the Medicare member of their financial responsibility. The form gives the patient options to choose from in regards to the service that is considered not medically necessary.
Balance Due Arrangements
Reasonable attempts will be made to communicate with patients regarding their account balances after their insurance has paid. ValleyCare Medical Group of Ohio will work with patients to reach agreeable resolutions within federal guidelines and company policy.
If a patient has no insurance coverage and an outstanding balance presents a severe hardship, patients should call the customer service department at 1-877-848-1457.
Collections
Any balance due from the patient will be communicated via a statement that is mailed to the patient's home address. If payment is not made or a payment arrangement has not been established within 90 days from the first statement the balance can be sent to a collection agency for further collection attempts.
Auto Insurance Liability
ValleyCare Medical Group of Ohio does not bill or become involved in disputes between patients and their insurance carrier when a service is related to an auto accident. Our policy is to bill the patient's medical insurance for the service provided notating the service is accident related. Ultimately it is the patient's responsibility to pay for the service provided.
Medical Records
Ohio law permits a fee to be assessed for the copying of medical records. The fee must be paid in full and a consent form signed by the patient or legal guardian prior to the release of records.