The financial side of health care can be stressful. You or your loved ones should be focused on getting and staying well, not wondering how to pay bills. We want to make the billing and insurance process as easy as possible.
Get an estimate for some of the most common tests and procedures.
If you don't have health insurance or can't afford care, we can help. There may be free or low-cost health care for people who meet certain requirements.
Our ProMedica hospitals are in the networks of most major insurance plans. Please refer to your insurance company’s provider directory, or speak to someone with your insurance plan to verify that we are in network with your plan.
Understand your co-payments, deductibles and coinsurance amounts before the time of service. Patients who need medically necessary treatment will be seen even if they're not able to pay these amounts. Patients that are self-pay or receiving elective services may be responsible for some payments at time of service. Call 844-373-0871 if you have any questions.
Contact your provider, the hospital where you will be recieving services, or your insurance plan directly if you have any questions or concerns about pre-certification or pre-authorization. It’s the best way to make sure you're fully informed about your insurance coverage.
If your insurance changes, please let us know before your appointment. You can update your insurance information online through ProMedica MyChart, or call the office or hospital where you have your next scheduled appointment. Be sure to bring your current insurance card to your next visit so your information can be confirmed, and your new insurance will be billed correctly (if needed).
Coordination of benefit rules apply. Contact your insurance provider or your employer to help you decide on the proper order for billing.
Under any plan, there may be services that aren’t covered. The insurance company may consider them routine, unnecessary or not a covered benefit. If you don’t agree with how your insurance company processed your claim, contact your insurance company.
If insurance payments for claims are sent directly to you (whether from primary or secondary insurance companies) you will need to use them to pay the charges you owe to ProMedica. Please endorse and forward the check to the correct hospital address. Whether the check is sent to you or to us, remember that as a patient, you will need to pay all remaining charges.
If insurance payments for claims are sent directly to you (whether from primary or secondary insurance companies) you will need to use them to pay the charges you owe to ProMedica. Please endorse and forward the check to the correct hospital address. Whether the check is sent to you or to us, remember that as a patient, you will need to pay all remaining charges.
If you are a parent or guardian of a child who is receiving health care services, you are the "guarantor" for the child. A "guarantor" is the person who will be billed and is expected to pay. You will need to come to the first office visit and sign the treatment authorization (the "authorizing parent/guardian").
The authorizing parent or guardian is responsible to pay for any visits after the first one — no matter who brings the child into the doctor's office. This applies to cases of divorce, annulment, dissolution of marriage or legal separation. Court orders or judgments don't impact our offices. Any payment issues must be resolved by the parents or guardians and the court system. Patients 18 years of age or older are considered the guarantor, no matter who carries the insurance.
We're considered "participating physicians." This means that we'll submit claims to Medicare on your behalf. Medicare will send a check to ProMedica Physicians for 80% of the approved amount, minus the patient's Part B deductible.
Please remember:
If you have more questions about Medicare or Medicaid, please see the resources below:
Self-administered drugs (SAD) are drugs you normally take on your own. You're sometimes asked to take your normal medicines during hospital procedures. Medicare has rules that determine whether those drugs are covered by Medicare. Download this SAD Coverage fact sheet to learn more.
Workers' compensation claims are your responsibility until a valid workers' compensation number is provided by your employer.
If your claim is refused by the Bureau of Workers' Compensation or becomes a legal case, we may bill your health insurance for the hospital charges. If you don't have health insurance, you may be able to get financial assistance.
In the state of Ohio, the injured worker or the employer can file a claim on the Ohio Bureau of Workers' Compensation's website. You'll need your employer's policy number with the Bureau of Workers' Compensation so you can file the claim. If you don't know your employer's policy number, you can search for it on the website when you file your claim.
In the state of Michigan, all employers are self-insured. You won't need to file a claim with the Workers' Compensation Agency. The hospital will bill the employer's third-party administrator (TPA) or the company itself. You'll need to give us the company name and address for the bill.
Auto accident claims are billed to the patient's medical insurance. Any co-payment, coinsurance, or deductible is your financial responsibility. If the insurance company denies the claim, you will need to pay the bill.
All deductibles, co-payments and patient balances are to be paid in full by the patient's 28th week of pregnancy. Monthly payments may be arranged with the office staff to satisfy this financial responsibility.