This information is provided to help answer your questions about the insurance and billing process. If you have further questions, please call us at 515-239-2111.
Will Mary Greeley Medical Center bill my insurance company?
We will bill your insurance company, but we need your complete insurance information.
An important point: We are not allowed legally to file claims resulting from motor vehicle accidents on behalf of the patient. The only exception is for Medicare and Medicaid patients; these government programs require us to file the claims. If your treatment is due to an automobile accident, we will bill your health insurance carrier. Most third-party insurance carriers do not have a clause to pay when the insured has been involved in a motor vehicle accident. You, the patient or guarantor, are expected to pay the balance of your account within 30 days of discharge. If you are not able to pay this balance by then, please ask to speak with one of our Business Office representatives.
What insurance information must I provide?
We will need the following information, usually listed on your insurance card:
- The name of your insurance company
- The name of your employer through which the insurance is obtained, if any
- The name of the person who is the subscriber or holder of the policy
- Your policy number
- Your group number
- Your insurance company’s billing address and phone number
If you are unable to provide insurance information at the time you preregistered or before your discharge, please call our Business Office at 515-239-2111 or email financialcounselors@mgmc.com within 24 hours of your outpatient visit or inpatient discharge. We will then collect your information and promptly file your claim.
How will I know if my insurance company will pay for my coverage?
Insurance companies continually change which health services require their preapproval to be covered under their policies. It is important for you to be aware of your insurance company’s specific requirements and, if necessary, to contact your insurance company before receiving these services.
We strongly recommend contacting your insurance company before your visit to see if pre-certification is necessary and to be aware of your policy’s benefits. If your insurance company reduces payment because of failure to obtain the required pre-certification, you are responsible for the balance of the bill.
Note: Insurance benefits may be different for outpatient services provided in a hospital rather than a clinic (i.e. cardiology, radiology, lab, physical, occupational or speech therapy, etc)
Some examples of good questions to ask your insurance company are: Is Mary Greeley Medical Center an in-network provider? What are my benefits for outpatient services I receive at Mary Greeley Medical Center?
We recommend that you ask for a statement of benefits covered from your insurance company. Our staff is also happy to help you make the appropriate connection with your insurance company.
If my insurance company requires a claim form, can Mary Greeley Medical Center still bill my insurance for me?
We will gladly bill your insurance company, but we will need you to complete and sign the claim form. Otherwise, the bill will be sent to you, and you will need to send it and the claim form to your insurance company
When will I receive my first bill from Mary Greeley Medical Center?
If you have insurance, we will send you a statement within 30 days of your insurance appropriately processing your claim.
If you do not have insurance, we will send a letter within 15 days after discharge with an estimation of charges. The letter will outline your payment options. You will then receive a statement within 30 days.
Letters are generated if the account is delinquent. Statements are generated monthly until the balance is zero or the account is turned over to a collection agency.
If you need help understanding your statement or want to request an itemized statement call us at 515-239-2111.
In addition to cash, check and money orders, we accept Visa, MasterCard, Discover and American Express as well as debit cards.
When am I expected to pay my bill?
Your bill is due within 30 days of receipt. If you are not able to pay your bill in full, we offer payment plans and Financial Assistance. Balances are automatically enrolled in a payment plan if we do not receive payment in full within 30 days. To adjust a payment plan or inquire about Financial Assistance please contact the Business Office at 515-239-2111. MGMC does not charge interest or service fees on our payment plans.
Financial assistance: We have taken on the responsibility of providing medically necessary care at a reduced fee or no charge to patients who meet certain means tests. Applicants must complete the
financial assistance application to be considered for financial aid. The financial counselor can help you complete the application.
Will my bill from Mary Greeley Medical Center include all charges from my hospitalization or outpatient procedure?
Most physician services, such as radiologists, anesthesiologists, pathologists, emergency department physicians, surgeons and other physicians, including specialists brought in to consult with the primary emergency department physician, are not included on your Mary Greeley Medical Center bill.You may receive separate billings for these services from the physician who rendered the service to you.
Will all charges for each of my visits and hospitalizations be on the same bill or account number?
At MGMC, everyone over 18 years old has their own account, we do not bill as a family. You will be assigned a six digit Guarantor Account Number. The guarantor account number will be the same any time you come back to MGMC. A seven digit account number will be assigned for each visit to MGMC. This account number is specific to each visit and is used to keep your visits separate for billing purposes.
Children under the age of 18 and dependent adults are assigned a seven digit account number under one of their guardian’s guarantor account numbers. This is usually based on who brings the patient in for their visit.
Will my insurance company pay for emergency care?
It depends. Many insurance companies require notification within a specific time period, often within 24 hours of an emergency room visit or emergency admission. Ultimately, it is your responsibility to make this notification. Again, we are happy to assist you in making the right contact with your insurance company.
You should know that failing to follow your insurance company’s rules on precertification or notification of an emergency may result in the
company’s refusal to pay for your care. This includes instances when the insurance company refuses to pay for care that it does not consider an emergency or life-threatening situation. Again, we suggest you obtain specific guidelines from your insurer.
What is precertification?
Many insurance companies require you, as the patient, to obtain prior
approval for care, other than an emergency situation, even if the care is considered to be medically necessary by your insurance company. This is called precertification and we suggest, for your benefit, that you obtain specific guidelines from your insurance company.
If your insurance coverage is through a managed care plan, your insurance company may require that you obtain a written referral or authorization from your primary care physician. This is important, as the insurance company may refuse to pay for non emergency care if you do not have a written referral.
Who is responsible for precertification?
Insurance companies require subscribers to precertify to avoid reduction of payable benefits. However, precertification does not guarantee payment.
What if my insurance company requires precertification, and my admission or outpatient visit was not precertified?
If your insurance company reduces benefits because of failure to obtain the required precertification, you are responsible for payment of that portion of the bill.
What does precertification NOT do?
Precertification does not check for a policy’s effective dates of coverage, pre-existing condition clauses, second opinion or waiting period requirements or available benefits. We recommend that you check these items with your insurance company.
What is elective surgery?
Elective surgery refers to a procedure that a physician may recommend but an insurance company may not consider medically necessary. In cases of elective surgery, many insurance companies require notification in advance of that surgery and admission. Your insurance company specifies how far in advance notification is required. You should inform our admissions office at 515-239-2959 of the required insurance information as soon as possible. We suggest that you request a written guarantee from your insurance company stating that it will cover your procedure.
If I do not have insurance, when is my payment due?
Payment for services is due in full 30 days after you receive your first bill from us. You can also make an appointment with one of our financial counselors to discuss alternate payment arrangements by calling 515-239-2111.
If I am in need of financial assistance, what do I do?
You can
learn more about financial assistance on our website or our financial counselors can provide you with information. Depending on your financial status, several programs are available to help with medical bills. If you would like to discuss financial assistance options, call one of our account representatives at 515-239-2111, or if you are an inpatient, ask your nurse to have a financial counselor come to your room.
What if I need help understanding Medicare?
Medicare counseling is available through our Volunteer Services
department. Volunteers trained by staff from the Senior Health Insurance Information Program (SHIIP) can help you with Medicare billing or in reviewing Medicare supplements or long-term care insurance.
Request an appointment online or call 515-239-2210.
What if my injury is the result of an accident at work?
We will file your claim to your employer or designated workers’ compensation carrier. For the claim to be considered as workers’ compensation, you must file a first report of injury at your place of employment. Upon entry into the medical center, please inform the admission staff of your supervisor’s name and phone number to verify if they consider the injury workers’ compensation.
Please also provide Mary Greeley Medical Center with your health insurance carrier to be considered as your secondary carrier.
