Do When Do You Think Youre and Get Bill to Get on Again
About your bill
What's included in your bill
For your convenience, Mass General Brigham (formerly Partners HealthCare) provides you with one bill. The following hospitals and physician practices are included on the Mass General Brigham bill:
- Brigham and Women's Faulkner Hospital
- Brigham and Women's Hospital
- Brigham and Women's Physicians Organization
- Cooley Dickinson Hospital
- Cooley Dickinson Medical Group
- Cooley Dickinson VNA & Hospice
- Martha's Vineyard Hospital
- Massachusetts Eye and Ear
- Massachusetts Eye and Ear Associates
- Massachusetts General Hospital
- Massachusetts General Physicians Organization
- Mass General Brigham Urgent Care (formerly Partners Urgent Care)
- McLean Hospital
- Mystic Healthcare
- Nantucket Cottage Hospital
- Newton-Wellesley Hospital
- Newton-Wellesley Medical Group
- North Shore Medical Center
- North Shore Physicians Group
- Partners HealthCare at Home
- Pentucket Medical Associates
- Spaulding Rehabilitation Network
- Wentworth-Douglass Hospital
- Wentworth Health Partners
However, please note: Services provided by private practices affiliated with Mass General Brigham (formerly Partners HealthCare) will be sent to you in a separate bill from those practices.
Your bill may contain both hospital and professional charges. Those could include services, such as the following: medical equipment, technology, medical supplies, lab tests, radiology, hospital rooms, as well as time the caregiver spends during the visit treating you, reading test results, and coordinating care.
If you are not sure how your health insurance plan will process claims for your doctor's site, contact Patient Billing Solutionsto ask what you'll pay out of pocket.
When you will receive your bill
Patients are billed as soon as possible after their visit or hospital stay. Bill cycles are every 30 days. Bills are not sent until all insurance claims have been processed for that visit. Patients without insurance receive bills directly. Once a bill is received, patients are given 25 days to pay their bills in full. The due date will be noted on your bill.
Mass General Brigham can arrange flexible payment options (payment plans) upon request.
If you have medical bills for which you cannot pay, please visit our Financial Assistance pageto learn more about options available to you.
Pay your bill
For your convenience, there are a few payment options to pay your bill:
Online
The most convenient, efficient way to pay your bill is online. If you have a Patient Gateway account, you can see the current status of all open patient balances; payments are immediately posted to your account. You can opt to go paperless and receive your bills online. You also can set up monthly payment plans.
Log in to Patient Gateway
Or if you do not have a Patient Gateway account, you can quickly pay as a guest.
Pay as guest
Call
You can also call617-726-3884 and press 1 to pay your bill by phone. Please have your account number and the patient's date of birth ready. You can check on your current account balance. Payments are immediately posted to your account.
Send a check or money order to Mass General Brigham (formerly Partners HealthCare System) to:
Mass General Brigham
P.O. Box 418393
Boston, MA 02241-8393
Include the coupon from the statement and write your account number (not medical record number) on your check. Checks sent to any other address may not get posted to your account.
Frequently asked questions
- Why did I receive a bill from Mass General Brigham (formerly Partners HealthCare)?
- You don't have health insurance.
- The service you received is not covered by your insurance.
- You have a co-payment, co-insurance, or deductible that you did not pay at your visit.
- You did not get a required referral from your doctor.
- You received care outside your provider network.
- You used up your insurance benefits. (Some health insurance companies limit coverage.)
- I have Health Safety Net (HSN). Why am I getting a bill?
If you have HSN, (also called Free Care), we bill you if:
- You have an HSN deductible.
- You have private insurance, and HSN but did not pay your private insurance co-payment at your visit
(HSN does not cover private insurance co-payments.). - You saw a doctor who does not accept HSN.
HSN is a state program that pays hospitals and health centers but not most doctors. The Mass General Physicians Organization, the Brigham and Women's Physicians Organization, the North Shore Physicians Group, and Newton Wellesley Ambulatory Services:
- Will not bill patients on Full HSN
- Will reduce bills for patients on Partial HSN by 70%
If your doctor is not a member of one of these groups, you may get a bill.
- Why am I getting more than one bill for the same service?
You may receive separate bills for services from the hospital and the doctor, such as bills from private practices affiliated with Massachusetts General Hospital and Newton-Wellesley Hospital.
The hospital portion is for items, such as medical equipment, technology, medical supplies, lab tests, radiology, and hospital rooms.
Theprofessional portion is for the time the caregiver spends during the visit treating you, reading test results, and coordinating care.
If you are not sure how your health insurance plan will process claims for your doctor's site, contact us at [email protected] or617-726-3884 to ask what you'll pay out of pocket.
- Why is my cost for a doctor visit different from the amount listed on my insurance card?
Some health insurance plans consider our health centers and physician practices to be hospital outpatient locations and not doctors' offices. This may change how your health insurance pays for your care.
That means if you visit one of these sites, you may be charged for a hospital outpatient service, rather than a doctor visit. Your co-payment, co-insurance, or deductible may be different from what they would be for a doctor visit.
Please read aboutbilling at hospital outpatient locations.
- Why did I receive a bill from a physician who I did not see?
Some visits also have charges for ancillary departments (e.g., Radiology, Pathology, Anesthesia, etc.); please check to see if your bill includes an ancillary charge.
If you still believe that you received a bill in error, pleasecontact Patient Billing Solutions.
- When will I receive a bill?
Patients are billed as soon as possible after their provider's appointment or hospital stay.
- Typically, bills are not sent until all insurance claims have been processed.
- Patients without insurance receive bills directly.
- Bill cycles are every 30 days.
- Once a bill is received, patients are given 25 days to pay their bills in full; the due date will be noted on your bill.
- Why didn't my insurance pay for my services?
Your insurance carrier will forward an explanation of benefits (EOB) for your review; the form explains the payment or denial reason for the services rendered.
- Why am I being charged a co-payment for my annual check up/Preventive Health Exam? My insurance plan doesn't require a co-payment for annual visits.
When you are scheduled for your annual Preventive Health Exam, there is typically no co-payment.
However, sometimes, your annual Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit can turn into a"Sick Visit."
During your visit, your provider may need to treat a new medical issue or a chronic problem that has changed. If that occurs, this part of the visit is called a Sick Visit and may result in additional services being billed to your insurance.
Most insurance companies will pay for Sick Visit evaluations, tests, and treatments, but your insurance plan may require you to pay a co-payment, deductible, and/or co-insurance payment for the Sick Visit, even when it is done during the same appointment as your Preventive Health Exam.
The office staff does not know at the time of check in what services will be provided during your actual visit, as this is between you and your provider. We will send you a bill if there is any unpaid balance after we receive payment for your visit from your insurance company.
It is important that you understand your health insurance benefits, and we encourage you to contact your health insurance plan if you have any questions about what is included in your Preventive Health Exam.
Please read our page aboutbilling for Preventive Health Exams.
- What if my address has changed?
- Why is my cost for an urgent care visit at a location affiliated with Mass General Brigham (formerly Partners HealthCare) different from what my health insurance company lists as my urgent care benefit?
Urgent Care services are available at multiple locations within Mass General Brigham. Some of those locations are not considered by health insurance plans to be Urgent Care Centers, and therefore,your co-payment benefits for urgent care services typically will not apply. Instead, your visit to these locations will likely be billed either as a physician office visit or a hospital outpatient visit.
The billing information below doesnotapply to Urgent Care services provided at centers named "Mass General Brigham Urgent Care" (formerly "Partners Urgent Care") located in Boston and surrounding communities. For visits to Mass General Brigham Urgent Care (formerly Partners Urgent Care), your urgent care insurance benefit typically will apply.
For physician office locations:
Urgent Care services are typically billed as a physician or nurse practitioner visit, and your out-of-pocket costs are usually limited to the co-payment required by your health insurance plan. We will request your co-payment when you check in for the visit.
For hospital outpatient locations:
Your out-of-pocket costs for the physician or nurse practitioner visit are usually limited to the co-payment required by your health insurance plan. We will request your co-payment when you check in for the visit.
You will also be billedwhat is commonly known as a "facility fee" for use of the hospital space, equipment, and support staff.
Your health insurance plan may apply these hospital fees to your annual deductible, and after you have paid your deductible in full, you may be billed for a co-insurance payment.
We will send you a bill if there is any unpaid balance after we receive payment for your visit from your health insurance plan.
Please read more information about urgent care billing, and find out which urgent care centers are considered physician office urgent locations and which are considered hospital outpatient locations.
- How can I pay my bill?
There are a few payment options.
- Pay your bill online atwww.patientgateway.org orpay as guest.
- Call 617-726-3884 and press 1 to pay your bill by phone
- Send a check or money order to Mass General Brigham to the following mailing address:
Mass General Brigham
P.O. Box 418393
Boston, MA 02241-8393 - Can I pay my bill with a credit card?
Yes, we accept Visa, MasterCard, Discover, American Express, and electronic checks.
Visithttps://www.patientgateway.orgto pay your bill online.
Please call Billing Solutions at617-726-3884 to process your credit card via the telephone.
- What if I cannot pay my entire bill?
- Who do I contact if I do not have insurance?
We offer several programs for patients who are under-insured or who do not have insurance coverage.
If you live in Massachusetts, you may be able to get health insurance or help paying your health care bills through a state program like MassHealth, the Health Connector, or Health Safety Net.
You can also speak with a patient financial counselor.Find where offices are located.
You can alsocontact Patient Billing Solutions with questions about what to do if you do not have insurance.
- What if my insurance information has changed?
- Do I have to submit my bill to my secondary insurance?
If we have all of your insurance information, we will bill your secondary insurance on your behalf.
- If I updated my insurance information, do I have to call my insurance company to pay my bill?
If you updated your insurance information with Patient Billing Solutions, we will re-submit your bill to your updated insurance company to request payment.
- What is the contact information for my doctor?
To find the contact information for your provider, including address and telephone number, please refer to ourFind-A-Doctor search tool.
Urgent care/walk-in billing
- Urgent care/walk-in billing
Urgent care/walk-in services are available at multiple locations within the Mass General Brigham (formerly Partners HealthCare) system.
Services Directory
The billing information belowdoes not apply to urgent care/walk-in care services provided at centers named "Mass General Brigham Urgent Care" (formerly "Partners Urgent Care") located in Boston and surrounding communities.
How urgent care/walk-in billing may affect me
Since the locations listed below are not considered by health insurance plans to be urgent care/walk-in centers, your co-payment benefits for urgent care/walk-in services typically will not apply. Instead, your visit to these locations will likely be billed either as a physician office visit or a hospital outpatient visit.
Physician office locations
Urgent care/walk-in services provided at the following Mass General Brigham locations are typically billed to your health insurance plan as a physician or nurse practitioner office visit:
- Brigham and Women's Health Care Center, Pembroke, MA
- Cooley Dickinson Urgent Care, Northampton, MA
- Harbor Medical Associates Urgent Care, South Weymouth, MA
- Nantucket Cottage Medical Group, Urgent Access Clinic, Nantucket, MA
- North Shore Urgent Care, Danvers, MA
- Pentucket Medical ExpressCare Andover, MA • Lawrence, MA
Hospital outpatient locations
Urgent care/walk-in services provided at the following locations are typically billed to your health insurance plan as a hospital outpatient visit:
- Brigham and Women's Urgent Care Center, Foxborough, MA
- Massachusetts General Hospital Chelsea HealthCare Center Urgent Care, Chelsea, MA
- Massachusetts General Hospital Primary Care Urgent Access Center, Boston, MA
- Newton-Wellesley Hospital Waltham Walk-In, Waltham, MA
Understanding whether my urgent care/walk-in visit takes place at a physician office or a hospital outpatient center
You can find information about whether your visit is a physician office or hospital outpatient visit in notices in our waiting rooms, on this website and the websites of our hospitals and physician groups, and via in-center printed guides.
Payment responsibility for urgent care/walk-in services at the locations listed above
For physician office locations:
Urgent care/walk-in services are typically billed as a physician or nurse practitioner visit, and your out-of-pocket costs are usually limited to the co-payment required by your health insurance plan.
We will request your co-payment when you check in for the visit.
For hospital outpatient locations:
Your out-of-pocket costs for the physician or nurse practitioner visit are usually limited to the co-payment required by your health insurance plan. We will request your co-payment when you check in for the visit.
You will also be billed for what is commonly known as a "facility fee" for use of the hospital space, equipment, and support staff.
Your health insurance plan may apply these hospital fees to your annual deductible, and after you have paid your deductible in full, you may be billed for a co-insurance payment.
We will send you a bill if there is any unpaid balance after we receive payment for your visit from your health insurance plan.
Referrals and prior authorizations
For both physician office visits and hospital outpatient visits, your health insurance plan may require you to get a referral or authorization. In addition, our providers may be considered "In Network" or "Out of Network" depending on the specifics of your health insurance plan, which could affect the amount you pay.
Billing for procedures performed during the visit
No matter the location, if a procedure is performed during the visit, you may have further out-of-pocket costs for additional physicians' services and for use of the hospital facilities and staff, even if the procedure was performed in the same exam room as the visit with the physician. Your health insurance plan may apply these additional physician and hospital charges to your annual deductible, and after you have paid your deductible in full, you may be responsible for an additional co-insurance payment.
Laboratory and imaging services
If your physician ordered laboratory tests or imaging services (such as X-ray, CT or MRI), you will be billed for these tests by the hospital, clinical laboratory, or imaging center, and you may also be billed for the services of the physicians (usually pathologists and radiologists) who interpreted the test results.
Special notice for Medicare patients
If you are a Medicare beneficiary and your visit takes place in a hospital outpatient location, you will be responsible for a Medicare Part B out-of-pocket co-insurance payment of approximately $25 for the hospital facility charge. Procedure charges or other testing could increase your out-of-pocket expense.
Understanding how much my visit will cost
It is your right toreceive an estimateof the cost of your visit in advance of the visit. Pleasecontact Patient Billing Solutions at least two business days prior to your visit to get an estimate. Please have as many details as possible about the upcoming visit, including the provider name, location, and details of the planned service or procedure.
Please contact the Member Services department of your health insurance plan to verify your coverage and financial responsibility for urgent care/walk-in services provided at any of the locations listed on this page. This phone number is usually located on your insurance card.
Updated November 2020
Preventive health exam billing
- Preventive health billing
What is a "Preventive Health Exam," and is it covered by my insurance?
A Preventive Health Exam is an Annual Physical during which your primary care provider will:
- Ask you questions about your health
- Do a physical examination
- Give you advice about how to prevent health problems
- Take care of minor health problems or a chronic illness that has not changed
Commercial health plans
Under the Affordable Care Act, commercial health plans are required to cover an annual Preventive Health Exam at no cost to the patient (no co-payment, co-insurance, or deductible).
Medicare Advantage
Many Medicare Advantage plans will also pay the full cost of Preventive Health Exams.
Medicare Part B
Annual Wellness Visit
Medicare Part B covers a different version of an annual visit, called a "Medicare Annual Wellness Visit." During your Medicare Annual Wellness Visit, your provider will:
- Ask you questions about your health, and family and social history
- Provide advice about how to prevent health problems, including a plan for screening in the future
- Screen you for depression and other mental health or safety concerns
A Medicare Annual Wellness Visitdoes not include a physical exam. If your provider does perform a physical exam during your visit to assess your health or treat any medical problems,you may be responsible for a co-insurance or a Medicare Part B deductible payment.
"Welcome to Medicare" VisitDuring your first 12 months of enrollment in Medicare Part B, a "Welcome to Medicare" visit is covered, which includes a physical examination.
When would any of these Annual Health Visits turn into a Sick or Chronic Disease Visit?
Sometimes, your annual Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit can turn into a "Sick Visit."
During your visit, your provider may need to treat a new medical issue or a chronic problem that has changed. If that occurs, this part of the visit is called a Sick Visit and may result in additional services being billed to your insurance.
Most insurance companies will pay for Sick Visit evaluations, tests, and treatments, but your insurance plan may require you to pay a co-payment, deductible, and/or co-insurance payment for the Sick Visit, even when it is done during the same appointment as your Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit.
Are lab tests for disease screening and immunizations covered during my Annual Health Visits?
Medicare and many commercial health insurance plans cover certain screening tests (such as cancer and cardiovascular disease screening) and immunizations. Specific coverage depends on your age and health insurance plan. Some tests and immunizations may not be covered at 100%, and some may not be covered at all. In those cases, you may be responsible for a co-insurance or deductible payment.
When will I have to pay?
We will request your co-payment when you check in for a visit. We will send you a bill if there is any unpaid balance after we receive payment for your visit from your insurance company.
It is important that you understand your health insurance benefits, and we encourage you to contact your health insurance plan if you have any questions about what is included in your Preventive Health Exam, Medicare Annual Wellness Visit or Welcome to Medicare Visit, or about charges for Sick Visits, lab tests, immunizations, and other services that are performed during your Preventive Health Exam, Medicare Annual Wellness, or Welcome to Medicare Visit.
If your insurance company does not answer all of your questions, please contact Patient Billing Solutions.
Updated April 2019
Physician office and hospital outpatient billing
- Physician office and hospital outpatient billing
Physician office billing
When your visit takes place in a physician office, you will usually be charged only for the physician's examination, and your co-payment will usually be your only out-of-pocket cost.
We will request your co-payment when you check in for a visit.
Hospital outpatient billing
When your visit takes place in a hospital outpatient location, there will typically be two charges, which may result in you paying more for your visit than if you are seen in a physician office. Your out-of-pocket costs could include the following:
- You will be charged for the physician's examination, which will usually be covered by your co-payment.
- You will also be charged by the hospital for use of hospital space, equipment, and support staff.This is commonly known as a "Facility Fee." Your health plan may apply these hospital charges to your annual deductible, and after using up your deductible, you may be responsible for a co-insurance payment.
You may receive a bill that combines the charges from the hospital and the physician on one line, or these charges may be split into two lines, depending on the location. We will request your co-payment when you check in for your visit, and we will send you a bill for any unpaid balances after we receive payment from your insurance company.
Understanding whether my visit is a physician office visit or a hospital outpatient visit
You can find information about whether your visit is a physician office or hospital outpatient visit in notices in our waiting rooms, on the websites of our hospitals and physician groups, and in electronic appointment reminders for your scheduled visits.
Referral and prior authorization
For both physician office and hospital outpatient visits, your health insurer may require you to get a referral or authorization. In addition, our providers may be considered "In Network" or "Out of Network," depending on the specifics of your health insurance plan, which could affect the amount you pay.
Billing for procedures performed during the visit
No matter the location, if a procedure is performed during the visit, you may have further out-of-pocket costs for additional physicians' services and for use of the hospital facilities and staff, even if the procedure was performed in the same exam room as the visit with the physician. Your health plan may apply these additional physician and hospital charges to your annual deductible, and after using up your deductible, you may be responsible for an additional co-insurance payment.
Laboratory and imaging services
If your physician ordered laboratory tests or imaging services (such as X-ray, CT or MRI), you may be billed for these tests by the hospital, clinical laboratory, or imaging center, and you may also be billed for the services of the physicians (usually pathologists and radiologists) who interpreted the test results.
Understanding how much my visit will cost
It is your right to receive anestimate of the cost of your visit in advance of the visit. Pleasecontact Patient Billing Solutionsat least two business days prior to your visit to get an estimate. Please have as many details as possible about the upcoming visit, including the provider name, location, and details of the planned service or procedure.
Special notice for Medicare patients
If you are a Medicare beneficiary and your visit takes place in a hospital outpatient location, you will be responsible for a Medicare Part B out-of-pocket co-insurance payment of approximately $25 for the hospital facility charge. Procedure charges or other testing could increase your out-of-pocket expense.
More information
Please contact the Member Services department of your health insurance plan to verify your coverage and financial responsibility for services described on this page. This phone number is usually located on your insurance card.
Updated April 2019
Virtual visit billing
- Virtual visit billing
Glossary of patient billing terms
Need more information on patient billing terminology? Use the glossary
Contact Patient Billing Solutions
Contact Patient Billing Solutions with any correspondence, including requests for information, offers to settle, disputes, or general notes about your bill.
Phone
(617) 726-3884
Monday - Friday: 9:00 a.m. – 4:30 p.m. EST
Email
[email protected]for general questions only; a representative will respond generally within three business days.
(Please use www.patientgateway.org to view details of your account, send messages with confidential information, or pay your bills.)
Mailing Address
Correspondence only (no checks)
Mass General Brigham
Patient Billing Solutions
399 Revolution Drive, Suite 410
Somerville, MA 02145-1462
If you would like to pay your bill, please refer to theHow to Pay Your Billinformation for specific instructions.
Source: https://www.massgeneralbrigham.org/patient-information/billing-and-insurance
0 Response to "Do When Do You Think Youre and Get Bill to Get on Again"
Post a Comment