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 check its requirements and to make sure Cleveland Clinic is in the network.
If Cleveland Clinic is “out of network,” may I still go there?
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. Be sure you understand your health plan's “out-of-network” options.
How can I be sure my insurance provider will pay my bills?
Some health plans require certain services to be authorized, or pre-certified, before the patient receives them. Other health plans require the patient to notify them within a certain period of time after services are rendered. Know 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.
Does Cleveland Clinic send the necessary information and paperwork to insurance providers?
We try to send all the necessary information to insurance providers; however, they sometimes need more information from you to process a claim.
How will I know how much I owe?
Your insurance provider will send you an Explanation of Benefits (EOB) notice that details the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to The Cleveland Clinic. Review your EOB carefully, compare it to your Cleveland Clinic billing statement, and call your insurance provider or a Cleveland Clinic billing representative right away if you have questions or concerns.
Also, many health plans require patients to pay a co-payment or deductible amount that may be due at the time of registration or discharge from the hospital.
How often will I receive a statement?
Statements are issued monthly. You will receive a statement every month until all payments are made, either by the insurance company or the patient.
What if there is a mistake on my statement?
If you have billing questions, call the Cleveland Clinic's Patient Financial Services Department at 216.445.6249 or toll-free 866.621.6385 between 7 a.m. – 7 p.m., Mon.-Fri.
Why does the statement show a total account balance when I have insurance coverage?
Most likely, Cleveland Clinic hasn't yet been paid by your insurance company. In most cases, your insurance company will make payment as long as the services are covered under your benefit plan. 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.
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?
Be assured that emergency service will never be delayed or withheld on the basis of a patient's ability to pay. If you do not have health insurance, call the Patient Financial Services Department at 216.445.6249 or toll-free 866.621.6385. The billing representative will review payment and financial assistance options that may be available to you.
What if I cannot pay the amount I owe in full?
Call the Cleveland Clinic's Patient Financial Services Department at 216.445.6249 or toll-free 866.621.6385 (select option 2) and inquire about applying for financial assistance or being set up on a payment plan. We will be happy to work with you to set up a mutually agreeable payment plan and to answer your questions. Partial payments made toward your balance will stop collection activity only if you have made payment arrangements with us. Please call us to make arrangements.
May I pay my bill with a credit card?
Yes. For your convenience, Cleveland Clinic accepts cash, personal checks, debit cards or money orders, Visa, MasterCard, Discover and American Express. We will charge your credit card only for the amount you authorize. Payment plans also may be arranged through the Cleveland Clinic's Patient Financial Services Department.
Why are there two charges for the same department and date of service listed on my bill?
Cleveland Clinic is one of the few hospitals in the area that sends a combined billing statement. This means that we bill you for both the doctor and the use of the hospital and equipment on the same bill. For example, if you saw a community (non-Cleveland Clinic) 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. Our method allows you to receive one bill and make one payment for both charges.
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. Please call us anytime you have a question about a charge on your bill.