Frequently Asked Questions

 

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Find answers to frequently asked questions about billing, insurance and provider-based billing, including Medicare.

»How often will I receive a Cleveland Clinic statement?

Every month, you’ll receive a statement that lists what your insurance company still owes and what you owe. Statements continue until all payments are made.

»Why does the statement show a total account balance when I have insurance coverage?

Cleveland Clinic probably hasn't yet been paid by your insurance company. However, if your insurance plan does not cover the services you received, you are financially responsible for them.

»What does “Physician Visit Level 3” refer to on my bill?

Cleveland Clinic uses five levels to describe the time and complexity of physician visits, with Level 1 being the lowest and Level 5 being the highest.

»What does “adjustment” mean?

“Adjustment” refers to the portion of your bill that your hospital or doctor has agreed not to charge you.

»What if I cannot pay the amount I owe in full?

In many cases, we can help establish a 3-month interest-free payment plan or loan. Partial payments made toward your balance will not stop collection activity unless you have made payment arrangements with us.

Call to discuss payment options:
Patient Financial Services Department
Phone:216.445.6249
866.621.6385 (toll-free)

»May I pay my bill with a credit card?

Yes. Cleveland Clinic accepts Visa, MasterCard, Discover and American Express.

»Why are there two charges for the same department and date of service listed on my bill?

We use a combined billing statement, which means that we bill you for both the doctor and the use of the hospital and equipment on the same bill. This allows you to receive one bill and make one payment for both charges.

At some other hospitals, if you saw a physician for an office visit and also had an X-ray, you would receive a bill from that physician for the office visit and a separate bill from the facility where you had the X-ray.

»Why was my last payment divided and applied to the bill in two separate places?

We post your payment to the oldest charges first. On your billing statement, we itemize both the charges and your payments by date.

»Why did I receive a bill for a doctor I did not see?

Certain physicians help with your medical care even though you may not meet them. Commonly, these are the doctors who read your lab results, X-rays and EKGs, among others.

»What if there is a mistake on my statement?

If you have billing questions, call the Cleveland Clinic's Patient Financial Services Department:
Hours: Mon. – Fri., 8 a.m. – 6 p.m.
Phone: 216.445.6249
866.621.6385 (toll-free)

»How do I know if Cleveland Clinic contracts with my health plan?

To receive full insurance benefits, some insurance providers require patients to receive services with “in-network” or “participating provider” hospitals and physicians. Call your insurance provider to make sure Cleveland Clinic is in your network.

»If Cleveland Clinic is “out of network,” may I still go there?

Yes. In an emergency, always go to the closest hospital. Your insurance provider generally will cover emergency department costs or transfer you to an “in-network” hospital if it is safe to do so.

If you choose to go to an “out-of-network” hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Call your insurance company to find out your health plan's “out-of-network” options.

»How can I be sure my insurance provider will pay my bills?

Your health plan may:

  • Require certain services to be authorized, or pre-certified, before you receive them
  • Require you to notify them within a certain period of time after services are rendered

Find out your health plan's requirements by reading the information given to you by your insurance provider or employer, or by calling your insurance provider directly.

You also may call a Cleveland Clinic billing representative to discuss insurance payment concerns at 216.445.6249 or 866.621.6385 (toll-free).

»Does Cleveland Clinic send the necessary information and paperwork to insurance providers?

Yes. However, they sometimes need more information from you to process a claim. If you’re unsure, you can contact your provider to make sure they have what they need.

You can also contact the Cleveland Clinic billing representative with questions at 216.445.6249 or 866.621.6385 (toll free).

»How will I know how much I owe?

Your health plan may require a co-payment or deductible that will be due during appointment registration or hospital discharge. Check with your provider on the amount that you will be responsible for at this time.

Following your healthcare services, your insurance provider will send you an Explanation of Benefits (EOB), which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Cleveland Clinic.

Review this EOB, compare it to your Cleveland Clinic billing statement, and call your insurance provider or a Cleveland Clinic billing representative if you have questions or concerns.

»Does Cleveland Clinic bill secondary insurances?

Yes, Cleveland Clinic is dedicated to helping you receive full benefits from your insurance provider. You will be asked to provide complete insurance information upon registration. Be sure you have a copy of your insurance cards at that time. As a service to you, we will submit secondary claims along with required EOBs to your insurance provider. However, if your insurance provider doesn't make payment within 60 days, we will ask you to pay the amount owed.

»What if I don't have health insurance?

Emergency service will never be delayed or withheld on the basis of a patient's ability to pay.

For general care, if you do not have health insurance, call:
Patient Financial Services Department
Phone: 216.445.6249
866.621.6385 (toll-free)

The billing representative will review payment and financial assistance options that may be available to you.

»What does “Hospital Services” mean on my bill? I didn’t go to the hospital for my care.

Medicare allows hospitals to bill for both the physician and hospital outpatient services, in two separate charges, when a patient is seen in a physician office owned by a hospital. Most hospitals have opted to utilize this approach to billing.

For many years, Cleveland Clinic has not billed for services provided in physician offices this way—instead patients receive only one charge that combines both physician and overhead expenses.

»How will “Hospital Services” be reflected on my billing statement?

Your billing statement includes two separate charges for each visit – one for the physician’s services and another for the hospital outpatient facility and technical services. The hospital outpatient facility and technical services charge will be clearly defined on your bill under the description “Hospital Services.”

»Will Medicare or my health insurance cover my healthcare services?

Most Medicare patients will be covered by their supplemental insurance and will not have to pay more out-of-pocket. Medicare patients without supplemental insurance will pay a small amount.

Patients with health insurance will need to check with their insurance provider to determine what will be covered by their insurance plan. Most patients will not have to pay any additional dollars out-of-pocket.

»What type of questions should I ask my health insurance company?

Ask whether it covers facility charges or provider-based billing. If it does, ask what percentage of the charge is covered.

Contact:

Patient Financial Services

Hours: Mon. – Fri., 8 a.m. – 6 p.m.
Phone: 216.445.6249
866.621.6385 (toll-free)


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