EMPLOYEE HANDBOOK NOVEMBER 2022

Provided below is a list of Frequently Asked Questions with regard to insurance billing. 1. Who will bill the patients insurance? The University Eye Center will first bill the health insurance company on your behalf. If the bill is unpaid because the insurance company states you no longer have health insurance coverage, we will send you a bill. If you have changed insurance companies, contact us as soon as possible so we may change the information on file and bill the account correctly. If your health insurance coverage is through Medicaid, Medicare, an HMO or Worker Compensation, you may not receive a bill. If your bill is denied or your HMO determines that a portion of the bill is a patient responsibility, you will receive a bill.

2. The patient called and stated they were seen by the UEC Optometrist several weeks ago, why haven't they received a bill?

For patients with health insurance: once their insurance company has been billed and has responded to us, we determine how much they may owe and bill them. Depending on how quickly the insurance company processes the bill, it may take 3 to 12 weeks for them to receive a bill.

3. The Patient wanted to know, why their billing statement had an adjustment amount?

"Adjustment" (discount) refers to the portion of their bill that the clinic has agreed not to charge. Insurance companies pay charges at discounted rate. The amount of the discount is specific to each insurance company. When the insurance company pays their portion, the discounted amount (adjustment) is taken off to show the true amount due from the patient (co-insurance). For example, a hospital may charge $10,000 for a surgery that their insurance has agreed to only pay $2,500. Of that $2,500, the patient would have to pay $500 if the patient's responsibility is 20%. After the insurance pays $2,000 and patient pays $500, the remaining $7,500 would be the adjustment.

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