Medical Center Bills and Insurance

Veterans Choice at McLaren

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Participating Health Plans

All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the medical center's billing procedures and charges.

  • If you have health insurance, we will need a copy of your identification card. Depending on the extent of your coverage and deductible requirements, you may be asked to pay a deposit.  We also may need the insurance forms, which are supplied by your employer or the insurance company. You may be asked to assign benefits from the insurance company directly to the medical center.
  • If you are a member of an HMO, a managed care plan, or a PPO, your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan's requirements are not followed, you may be financially responsible for all or part of the services provided by the medical center. Some physicians may not participate in your health care plan, so their services may not be covered.
  • If you are covered by Medicare, we will need a copy of your Medicare card to verify eligibility and to process your Medicare claim. You should be aware that Medicare specifically excludes payment for certain items and devices, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations, and others. Deductible and co-payments are the responsibility of the patient.
  • If you are covered by Medicaid, we will need a copy of your Medicaid card.  Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary.
  • If you do not have insurance, a financial counselor from the Patient Accounting Department will discuss financial arrangements with you, or if requested can provide an application for financial assistance.

Billing

McLaren Flint is responsible for submitting bills to your insurance company and will do everything to expedite your claim. Your insurance policy is a contract between you and your insurance company, and you have final responsibility for payment of your medical center bill.

Your medical center bill reflects all services you received during your stay. Charges fall into two categories: a basic daily rate, which includes your room, meals, nursing care, housekeeping, telephone and television; and charges for special services, which include items that your physician orders for you, such as X-rays or laboratory tests.

If you have certain tests or treatments in the medical center, you may receive bills from physicians you did not see personally. These bills are for professional services provided by these doctors in diagnosing and interpreting test results while you were a patient.

Pathologists, radiologists, cardiologists and other specialists perform services, and are required to submit separate bills. If you have any questions about these bills, please call the number printed on the statements you receive.

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Hospital-based physician practices and Provider-based Billing

We have made some important changes recently in the way we bill our patients and third party payors including insurance companies, Medicare, Medicaid and other governmental programs.  These changes are similar to those being made at hospitals and physician practices across the country. 

McLaren is taking a more active role in the care delivered in physician offices owned by McLaren where most of our patients’ day-to-day medical needs are met.  As a result, McLaren converted many of its physician clinics to hospital-based outpatient clinics.  Hospital-based outpatient clinics help increase collaboration between hospitals and physicians by emphasizing better coordination and communication between physician offices and the hospital, focusing attention to quality and clinical outcomes.

Physicians now have access to all your hospital and McLaren physician office medical records to better coordinate your care.  Hospital-based outpatient clinics must meet the same stringent level of inspections, regulations and accreditation standards as those of our full service hospitals.  These requirements require additional resources.  To partially cover the increased costs, Medicare and Medicaid allow the hospital to bill as a “hospital outpatient”.  This is known as “provider-based billing”.

If you rely on Medicare, Medicaid or other form of governmental health insurance, these changes will mean that you will receive two bills covering the care that you received

  • One for hospital-based services such as x-rays, laboratory work, procedures, supplies, and work of the medical assistant and other office staff (sometimes referred to as a “facility fee”)
  • The other for care delivered by the physician, physician assistant, or nurse practitioner. These statements will show any amount owed for the visit, as determined by your insurance plan’s specific benefits. 

Hospital-based clinic billing does not affect patients with commercial health insurance plans - only affects those patients with Medicare, Medicaid, or other governmental plans.

As your health care provider, McLaren is committed to offering you the best care possible.  We are also committed to helping you understand our financial and billing policies, so if you have questions regarding these billing policy changes, please feel free to contact us.

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