Insurance and Billing

Insurance Assistance

McLaren Macomb's Financial Clearance Department can assist you in understanding your insurance and their requirements for prenotification / authorization. Services that they can provide you assistance with insurance questions are:

  • Inpatient hospitalization
  • Outpatient Surgeries
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • Sleep Studies
  • Infusion Services

If you have questions regarding the requirements of your insurance for the above services, please call (586) 493-8117. If you have questions regarding coverage or benefit levels, you should contact your insurance company directly. Note: verification of benefits is not a guarantee of payment. Your insurance company makes the final determination on payment of benefits.

The Financial Clearance Office is located on the first floor of the Medical Office Building. It is the first suite off the second hallway on the right ( south ) side. The door to the suite is on the left side of the hallway. You can ask for directions at the information desk as you enter the Medical Office Building.

Billing

McLaren Macomb will bill your insurance as a service to you. You must provide us with all the necessary information your insurance company requires in order to produce a bill. Once your insurance company responds to our bill, we will notify you of any patient responsibility amounts such as copays and deductibles or in the case the bill was rejected out right.

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.

Payment

We accept checks, money orders, VISA, Master Card, and Discover cards. You may also pay in cash at our Cashier's office or at one of our Point of Service Collection sites. Staff at the Point of Service sites will let you know if they are also a collection site which, can process your payment. The Cashier's office is located on the first floor of the hospital. It is just past the Medical Office Building up several steps on the right side.

If you have questions regarding your bill, we have staff that can assist you. Please call (586) 741-4220 with questions related to your bill. If you have questions related to your benefit level or the amount your insurance paid, it is best to contact your insurance directly. Your insurance company makes the final determination on benefits paid.

Veterans Choice at McLaren

Participating Health Plans