Frequently Asked Questions About Billing

Who can I contact with questions about my bill?

If you have questions about your bill, you can speak to a Customer Service representative by calling 866.621.6385 (Monday - Friday; 8 a.m. - 5 p.m. EST), or scheduling a call back.

If you have questions about financial assistance, you can speak to a Patient Financial Advocate by calling:

• 855.831.1284 (Monday - Friday; 8 a.m. - 5 p.m. EST).
• 954.689.5610 for Weston, Florida.
• Schedule a call back.

How long does it take to be billed?

The time it takes to receive a bill varies depending on your insurance company. Your insurance determines whether or not you are financially responsible for a portion of services based on your deductible and coverage. You should receive an Explanation of Benefits from your insurance company informing you of claims submitted, how much is being covered by the insurance company, and how much you will owe. Once your insurance company has processed the information, you will receive a bill.

Will I receive one bill for all services provided at Cleveland Clinic?

Nearly all Cleveland Clinic services will be on a single billing statement. However, some services - including some physicians who practice at our community hosptials, some radiology, anesthesiology, and certain laboratory services - continue to bill separately.

If you were transported by ambulance or helicopter, you may receive a separate bill from the medical transport company.

How do I make sure I’m not surprised by the amount of my bill?

To help ensure a smooth billing process, we encourage you to take these steps before your visit at Cleveland Clinic:

1. Confirm that your insurance is accepted at Cleveland Clinic or call your insurance company to find out if it has a contract with Cleveland Clinic.
2. Check your insurance plan to find out what is and isn't covered and whether or not your service requires authorization.
3. Confirm the copay amount for your visit, as well as any unmet deductible amount.
4. Be aware of your coinsurance and out-of-pocket maximum.
5. Update your coordination of benefits with your insurance plan.
6. If you do not have insurance, review our financial assistance programs.

How can I request an itemized statement?

Itemized statements can be requested in 2 ways:

1. You can speak to a Customer Service representative by calling 866.621.6385 (Monday - Friday; 8 a.m. - 5 p.m. EST), or scheduling a call back.
2. By emailing Customer Service.

If you send health information to Cleveland Clinic via email, please know that your message may be sent in an unencrypted email. An unencrypted email means there is a risk that the information in the email and any attachments could potentially be read by a third party when it is sent through the internet.

How do I pay my bill?

Cleveland Clinic accepts the following forms of payment and does not charge any processing fees:

• Check or money order.
• All major credit cards.
• Electronic checks.
• Payroll deduction (Cleveland Clinic employees only).
• Health Savings Account (HSA).

Patients can pay their bill online through MyChart. Patients can pay in person at any of our check-in desks, cashier offices or with our Patient Financial Advocates.

Cleveland Clinic also accepts payment by phone 24/7 for no additional charge at 216.445.6249 or toll free at 866.621.6385 and by mail using the detachable portion of your billing statement.

Cleveland Clinic provides alternative financing options for patients that need help paying their medical bills. Learn more about the zero interest payment options available.

Who can assist me with MyChart online bill pay?

You can speak to a Customer Service representative by calling 866.621.6385 (Monday - Friday; 8 a.m. - 5 p.m. EST), or scheduling a call back.

What financial assistance options does Cleveland Clinic offer?

If you do not have insurance, or are recently unemployed and no longer covered by insurance, you may qualify for financial assistance. Even if you have insurance, financial assistance may be available under certain circumstances. Our Patient Financial Advocates and our Customer Service Representatives will be glad to tell you about our financial assistance programs and how to apply for them. A summary of the Cleveland Clinic financial assistance policy and application can be found on our Financial Assistance page.

What is a facility fee/treatment room charge?

The facility and/or treatment room charge is the result of Cleveland Clinic’s physician offices and outpatient clinics being classified as hospital outpatient departments, also called provider-based facilities.

Provider-based billing applies to all patients, regardless of the type of insurance you have. Facility fees also apply to scheduled virtual visits. Virtual visit facility fees support the necessary digital health technology and healthcare services of a provider, which would otherwise be delivered in an outpatient setting. The way your insurance covers facility and/or treatment room charges will be different, based on whether you have insurance through your employer, another insurance company or if you are covered by Medicare.

What does “Hospital Services” mean on my bill?

Hospital Services covers the use of the room and any medical or technical services, supplies or equipment. The facility and/or treatment room charge will be shown here.

Why are there two charges for the same service listed on my bill?

One charge is for the professional services provided by your physician. The other charge is for the facility, which covers the use of the room and any medical or technical supplies, equipment and support staff.

Why is my Minimum Amount Due different than my Total Patient Balance?

Minimum Amount Due is the minimum amount of the bill that must be paid for the current billing statement. The Total Patient Balance is the total amount owed.

Why do the colors of the boxes change to yellow and red on my statement?

If an amount is highlighted in yellow, it means that the charge is past due. If it is highlighted in red that means this is your final notice for this charge and it may be sent to a collection agency if not paid in full by the due date.

When will I receive an estimate?

If you have an accepted insurance plan, you will receive an estimate for surgeries and diagnostics, like CT scans and MRIs, at the time the procedure is scheduled. You can also request an estimate from a Patient Financial Advocate. If you do not have insurance, or your coverage is not accepted at Cleveland Clinic, you will receive an estimate for all services. You can produce your own estimate for certain services through our self-service estimate tool.

• Review a visual guide to help you understand what your estimate will look like.

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

Before your visit at Cleveland Clinic, confirm the following with your insurance company:

• Is my insurance is accepted at Cleveland Clinic?
• Which services are and are not covered under my plan?
• Does my service requires authorization?
• Are my copay amounts different for different types of services?
• What are my deductible, coinsurance, and out-of-pocket amounts?

What will I owe at the time of my visit?

Copays are due at the time of service, per your insurance plan. If an estimate was provided to you prior to your visit, a portion of that amount may be requested at the time of your visit. If you have any outstanding balances, you may be asked to pay your balance or make payment arrangements.

How do my deductible, coinsurance, copay, and out-of-pocket maximum work together?

Our accepted insurance page helps explain basic insurance terminology and what your insurance company may pay for in regards to your hospital visit. We have also included a helpful video on that page to explain how your deductible, coinsurance, copay, and out-of-pocket maximum work together.

Is my insurance accepted at Cleveland Clinic?

There are three ways to find out if Cleveland Clinic accepts your insurance:

1. Look for your insurance plan on our accepted insurance page.
2. A scheduler can check if your insurance is accepted when you call to schedule your visit.
3. Ask your insurance company if it has a contract with Cleveland Clinic.

Please inform Cleveland Clinic of any secondary or supplemental insurance that you have.

What is an Advance Beneficiary Notice (ABN)?

Sometimes, Medicare will not pay for tests even if your doctor believes they are medically necessary. When that happens, Cleveland Clinic must ask the patient to pay for these services. Signing the ABN is an acknowledgment of Medicare's possible non-coverage and your financial responsibility. For more information, please visit medicare.gov or call 1.800.Medicare.

How will changes to Medicare policy regarding the classification of surgeries affect me?

The Centers for Medicare & Medicaid Services has recently changed the Medicare guidelines affecting the way surgeries are classified, beginning January 1, 2021. Prior to 2021, CMS required that certain surgical services be scheduled as an inpatient surgery. Effective, January 1, 2021, based on your medical history, your surgeon will determine whether you should be outpatient or inpatient. If your physician expects that you will need to stay in the hospital less than two nights, you will have outpatient surgery. Your doctor and your medical team will monitor your progress very closely. If your doctor determines that you should stay longer, you will.

If you only have Medicare coverage, and no secondary insurance, as an outpatient surgical patient, you may have more out of pocket expense. To better understand your benefits and potential financial liability, you can:

• Speak with a Cleveland Clinic patient financial advocate at 855.831.1284.
• Email a Cleveland Clinic patient financial advocate at insurancehelp@ccf.org.
• Schedule an appointment to meet with a patient financial advocate via MyChart or clevelandclinic.org.
• Contact your insurance plan to understand your coverage.

What is a Medicare Wellness Visit?

A Medicare Wellness Visit is a yearly appointment with your primary care provider which includes a review of your medical and family history as well as routine measurements like your height, weight and blood pressure. During this visit, you and your provider will also complete a Health Risk Assessment and develop a personalized prevention plan to help you stay healthy. You pay nothing for this visit. However, the Part B deductible may apply if your doctor performs additional tests or services during the same visit. To understand the limitations of a free Medicare Wellness Visit, please visit medicare.gov or call 1.800.Medicare.

How will I be covered if I am placed under observation status as a Medicare patient?

Observation status is covered by Part B, and the annual deductible and copay apply. Observation status is not considered a hospitalization and does not affect your Medicare Part A benefits. No hospital days are used and the Part A deductible is not required. Medicare does not pay for self-administered drugs while you are in observation status. For more information, please visit medicare.gov or call 1.800.Medicare.

Are self-administered drugs covered by Medicare?

Part B doesn't cover “self-administered drugs,” prescription and over-the-counter drugs you get in an outpatient setting. Also, for safety reasons, many hospitals have policies that don’t allow patients to bring prescription or other drugs from home. You’ll likely need to pay out-of-pocket for these drugs and submit a claim to your drug plan for reimbursement. Call your drug plan for more information.

What is MyCare Ohio?

MyCare Ohio is the state’s first integrated care delivery system that coordinates the physical, behavioral and long-term care services for individuals enrolled in both Medicare and Medicaid. By helping these patients better coordinate their benefits in both programs, MyCare Ohio hopes to improve the quality of their healthcare and outcomes, as well as contain costs. For more information or to enroll, call the Ohio Medicaid Consumer Hotline at 1.800.324.8680, or visit ohiomh.com.

How do I select a Medicaid Managed Care Plan (MCP)?

If you want to have access to Cleveland Clinic for your care, you can select a Medicaid plan which includes Cleveland Clinic through the Ohio Medicaid Consumer Hotline at 800.324.8680. You can also visit ohiomh.com.

How can I get help understanding if I'm eligible for Medicaid?

From medical bills to health insurance, we're committed to helping you get the help you need to pay for your care. That's why we work with Centauri Health Solutions. If Centauri Health Solutions contacts you, please reply.

Their staff can help you find out if you qualify for help. Then, they'll walk you through enrolling in government or other benefit programs. These offer:

• Help paying for medical expenses.
• Help with your bills while you're on disability.
• Resources for transportation, food and housing in your community.

You'll get this help free of charge. Centauri isn't a collection agency or a bill collector.

Want to find out if you can get help through Centauri? Call 1.888.860.3537 today.