Billing and Financial

Policy:

A specific process will be implemented to assure consistent billing, financial, and collection processes and follow up on overdue accounts.

 

Billing and Insurance

Central Montana Heart and Vascular Institute LLC is committed to providing the highest level of professional medical service. As the patient it is your responsibility to meet any financial obligations. While we accept many different insurance plans, it is impossible for us to know all covered benefits, co-pays and deductibles for each plan. It is the patient’s responsibility to ensure coverage and that all services rendered on behalf of the patient are paid in full.

 

As a courtesy, our office will file all billing claims with insurance companies we contract with and submit any necessary documentation. You are responsible to assure our office has the most current insurance information on file. Failure to supply us with current insurance will result in delayed billing and could result in the balance becoming your responsibility.

 

For VA patients seen urgently in the hospital, we will bill the VA for these services. The VA doesn’t guarantee payment of these services, they approve based on specific criteria. If denied, we will bill other insurance coverage if we’re aware of the additional coverage. It is the patient’s responsibility to assure we have the appropriate insurance information. In the case that we don’t have any information on additional coverage for the patient or if for any reason a third-party payor does not provide payment for services rendered, the unpaid balance owed for such services will become a patient responsibility.

 

In order to accommodate the needs and requests of our patients and community our office is enrolled in most managed care plans. Please inquire with our office if we’re not participating with your specific managed care plan.

 

If you have insurance but ask that we don’t bill your insurance you will be required to sign a “Patient Request for Restriction of Use or Disclosure form.”

 

Payment

Patients are financially responsible for all charges and any cost incurred directly or indirectly to collect amounts owed under this policy, such as collection costs, attorney fees, late fees, and any other fees stated elsewhere.

 

All co-payments ARE DUE AT THE TIME OF SERVICE. Any patient balance owed is due upon receipt of the first billing statement.

 

We offer the following discounts:

  • Clinic Visits - Full balances paid within 30 days from the date of service – 10% cash/check discount or 5% credit card discount.

  • Procedures  - Full balances paid within 30 days from the date of service – 15% cash/check discount or 10% credit card discount.

  • Full Pay (No Insurance) – Full balances paid within 30 days from the date of service – 15% cash/check discount or 10% credit card discount.

 

If you can’t pay your full balance in full within 30 days from the date of service you can request a payment plan with our biller. Payment plans, terms and conditions of plans are further defined below and in collections.

 

Fees incurred from the appointment policy will need to be paid before any further appointments will be scheduled.

 

Payment Plans:

Balances will not be carried in the office past 12 months. Payment plans must remain current at all times. If monthly payments are missed the account will be turned to the collection process.

  • $1000 or less – expected pay off in 6 months. The amount will be calculated into 6 monthly payments.

  • Over $1000 – expected pay off in 12 months. The amount will be calculated into 12 monthly payments.

  • Balances under $100 for deceased patients will be written off.

 

 

Collections Procedure

  • Statements - Patients receive their first statement after insurance has paid or denied.  Statements are sent once a month.

  • 10 Day Notice - If no response from second statement (60 days), a 10 day notice will be sent with the third statement (90 days). A phone call will also be made the day the notice is sent.

  • If no response following the 10 days, the patients name will be added to the collections list.

  • All accounts being sent to collection will be reviewed by the management team. Special circumstances will be reviewed on a case by case basis with the management team. If a different course of action is deemed necessary based on the circumstance, patient will be notified in writing.

  • Collections – at this point repeated attempts to contact the patient regarding their balance have been unsuccessful and the account is turned to collections following approval from the office. At this time the balance is written off our books and handled strictly through the collection agency. Approximate turn over time for collections is 120 days.

  • PARM (Professional Accounts Receivable Management) – If a patient requests a payment plan and isn’t able to pay it off within the guidelines (6 months $1000 or less, 12 months over $1000) the account will be transferred to PARM where the patient can continue to make monthly payments. PARM will directly manage the payment plans and payments will be made directly to them. PARM charges 8% interest on these accounts. Once transferred to PARM, the patient account will be adjusted off our books.

  • We will make every attempt to work with patients on their accounts. Accounts are turned to collection only as a last resort when the patient has made no attempt to pay. Any account in question, elderly, financial hardship, etc., will be reviewed on a case by case basis with the management team. If a different course of action is deemed necessary based on the circumstance, patient will be notified in writing.

  • Patient’s turned to collections will not be able to be seen in the office for further appointments without insurance coverage and payment at the time of service for any co-pay or deductible amounts. Patients will be notified of this in writing.

 

Refunds

In the event of an overpayment on your account, a thorough review of the account will be conducted to determine the cause of the credit balance. If future appointments are scheduled where the credit balance can be applied we will do so, unless otherwise requested. If no future appointments are scheduled we will issue a refund. We will make every effort to handle all refunds to the patient or insurance company in a timely manner.

 

Returned Checks

A $30 fee will be charged on all returned checks.

Central Montana Heart & Vascular Institute, LLC

401 15th Ave S, Suite 202

Great Falls, MT 59405

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