Navigating medical billing can often feel overwhelming. At Aurora Health Care, we are committed to providing transparent and understandable billing practices. This guide aims to clarify common questions and concerns regarding your Aurora Health Care medical bills, ensuring you have the information you need to manage your healthcare finances effectively. Understanding the intricacies of medical coding and billing processes can empower you to better comprehend your statements and confidently address any questions that may arise.
Decoding Your Aurora Health Care Bill
Why Am I Receiving Multiple Bills?
It’s not uncommon to receive more than one bill from Aurora Health Care. This typically occurs in two scenarios:
- Multiple Family Members: If you are responsible for the healthcare costs of several family members and haven’t set up a family billing account, you’ll receive separate bills for each individual. Consolidating these into a single family billing account simplifies payment management. To establish a family billing account, please contact our Patient Contact Center at 800-326-2250.
- Combined Services: If you or a dependent received services from both an Aurora Health Care clinic or hospital and Aurora Health at Home around the same time, you will receive separate statements. These are distinct service areas with independent billing systems.
Preventive Services and Unexpected Bills
It can be surprising to receive a bill for preventive services, especially if you have 100% preventive care coverage. This often happens when a routine preventive service uncovers an underlying medical issue. In such cases, the nature of the service shifts from preventive to medical. Consequently, your insurance company processes the claim using your medical benefits rather than preventive benefits, potentially leading to out-of-pocket costs. This shift in medical coding is crucial as it determines how your insurance processes the claim.
Understanding Payment Due Dates
When you have a balance due, you will receive a billing statement either by mail or electronically through your LiveWell account. The exact due date is clearly indicated on your statement. If the statement indicates “now” as the due date, prompt payment is appreciated upon receipt and before the next billing cycle.
Credit Balances and Refunds Explained
If your account reflects a credit balance, rest assured that it is automatically reviewed by our team. There is no action needed from your side. If a refund is due, it will be automatically processed and mailed to the original payer.
Facility Fees: What Are They For?
A facility fee may appear on your bill if you received outpatient clinic services within a hospital setting. This fee covers the operational costs associated with the hospital facility, including resources such as nursing staff, administrative support, medical supplies, and specialized equipment.
Observation Status vs. Inpatient Stay
Sometimes, patients who stay overnight in the hospital are surprised to find their insurance processed the claim as an outpatient stay. This usually occurs when a doctor places a patient under “Observation status” upon admission. This status allows for a period of monitoring to determine if inpatient admission is necessary or if outpatient treatment is sufficient. For Medicare patients, this observation period can last up to 48 hours. If your stay was classified as observation and your doctor determined inpatient care wasn’t required, it will be billed as outpatient, even if it included an overnight stay. The accurate medical coding of your stay is essential for proper insurance processing.
Medical Coding Accuracy and Insurance Claims
It’s understandable to want to adjust medical coding to potentially alter insurance payments. However, Aurora Health Care employs certified medical coders who adhere strictly to federal and state coding regulations. They ensure accurate coding based on the documented services provided. While we are happy to review coding for accuracy against medical records, we cannot alter codes solely to increase insurance payouts. Our commitment is to ethical and accurate medical coding practices.
Will You Receive a Bill? Understanding Your Responsibility
After your insurance company processes your claim and pays their portion, you may receive a bill for the remaining balance. This statement will detail the insurance payment and your outstanding responsibility.
Aurora Health Care offers multiple convenient payment options:
- Phone: Call 800-326-2250 to speak with a representative or use our automated system.
- Online: Access your LiveWell account or use our secure online bill pay portal.
- Mail: Send your payment to Aurora Health Care, P.O. Box 809418, Chicago, IL 60680-9418.
Accessing Copies of Your Medical Bills
For easy access to your medical bills, log in to your LiveWell account. Alternatively, you can request a copy via mail, fax, or email by contacting our Patient Contact Center at 800-326-2250.
Need Help Understanding Your Bill?
If any aspect of your bill is unclear, our Patient Contact Center is ready to assist. Call 800-326-2250 for clarification and answers to your billing questions.
Payment Already Made? Let’s Investigate
If you believe your bill has already been paid, it’s possible that your payment and the statement crossed in the mail. Contact our Patient Contact Center via email or phone (800-326-2250) to verify your payment status. We apologize for any confusion and appreciate you informing us if you receive duplicate statements.
Convenient Ways to Pay Your Medical Bill
Aurora Health Care offers several hassle-free payment methods:
- Online: Through your LiveWell account or our secure online portal.
- Phone: Use our 24/7 automated pay-by-phone system at 800-326-2250.
- Mail: Send a check to the address provided on your statement.
Accepted Payment Methods
We accept various payment methods for your convenience:
- Credit/Debit Cards: MasterCard, Visa, Discover, and American Express are accepted online or by phone (800-326-2250).
- Electronic Funds Transfer (EFT): Pay directly from your bank account through your bank’s website.
Navigating Insurance and Billing
Who Is Billed For Your Visit? Providing Accurate Insurance Information
To ensure accurate and timely claim processing, please provide complete health insurance details when scheduling your service. This includes information for all insurance plans you intend to use. If you don’t have this information during scheduling, it’s crucial to provide it at check-in.
For services related to workplace injuries or illnesses, provide employer details and workers’ compensation coverage information. In cases of accidents where a third party may be liable, we will initially bill your medical insurance, who may then coordinate with the third party for payment. If you lack health insurance in such situations, we offer a one-time courtesy billing to the third party’s insurance. However, follow-up for payment becomes your responsibility after this initial billing.
Confirming Insurance Coverage: CPT Codes and Your Plan
To confirm your insurance coverage for specific services, you’ll need to understand the services you’ll receive and how they will be medically coded and billed. Request the Current Procedural Terminology (CPT) codes for your planned services. With these CPT codes, contact your insurance company to verify coverage details and understand your expected out-of-pocket costs. Understanding medical coding helps you proactively manage your healthcare expenses.
Updating Your Insurance Information
To update or change your insurance details, simply call us at 800-326-2250 during business hours.
Cost Estimates Before Service
For cost transparency, Aurora Health Care provides free cost estimates through LiveWell, showing potential out-of-pocket expenses for hospital and professional services. You can also obtain estimates by calling 800-326-2250. Remember that final bills reflect actual services rendered and may slightly vary from estimates due to unforeseen necessary treatments.
Options for Uninsured Patients
If you lack health insurance, Aurora Health Care automatically provides a 50% discount on medical service bills. For further assistance or questions, call 800-326-2250 or visit our facilities to speak with a financial counselor.
Disagreeing with Insurance Claim Processing
If you disagree with how your insurance company processed your claim, initiate an appeal directly with them. Follow their outlined grievance process in your policy. If your employer is self-insured, contact your employer to begin a review.
Urgent Care Billing Variations
Urgent care service billing can differ based on whether the center operates as a hospital outpatient department or a clinic-based department. Insurance companies may process claims differently depending on this distinction and your specific benefits. We can provide records to your insurer confirming the urgent care service. Contact the Patient Contact Center at 800-326-2250 to request a courtesy appeal on your behalf.
How Urgent Care Services Are Billed
Urgent care visits at Aurora clinics are billed as physician office visits, not as “urgent care” visits. Your billing statement may not explicitly mention “urgent care.” The co-pay collected at urgent care will be an office visit co-pay. Understanding your insurance coverage for physician office visits is essential. Contact your insurer to clarify your coverage and co-pay responsibilities.
Checking Claim Submission to Insurance
Allow up to 60 days for insurance claim submission and processing. If you didn’t provide insurance information initially or if it’s been over 60 days without insurance contact, please email or call our Patient Contact Center at 800-326-2250.
Payment Options and Assistance
Payment Expectations and Due Dates
Payment due dates are clearly stated on your billing statement, received by mail or through your LiveWell account. “Now” as a due date signifies immediate payment upon receipt.
Discounts for Uninsured Patients
As previously mentioned, uninsured patients receive an automatic 50% discount on Aurora Health Care medical bills.
Obtaining Cost Estimates
Yes, you can obtain cost estimates for future services by contacting us at 800-326-2250. Final charges may vary based on actual services provided during treatment.
Combining Accounts and Payment Arrangements
We strive to assist with combining accounts for simplified bill management whenever feasible. However, account combination is not always possible in all situations.
Discounts for Full Payment
Unfortunately, we do not offer discounts for full bill payments.
Payment Allocation Across Services
Payments are applied to the oldest outstanding service balance on your account first. Any remaining amount is then applied to the next oldest service. This may result in partial payments across multiple services, reflected on your statement.
Handling Multiple Payers and Credit Balances
If multiple parties contribute to payment, or if insurance coverage is unclear, and a credit balance arises, our dedicated Aurora team automatically reviews the account for refund processing. Refunds are issued to the appropriate payer (individual or insurance company, with written request required from insurers).
Financial Counseling and Assistance
Aurora Health Care offers financial counseling services to assist patients concerned about healthcare costs. Our Financial Advocates can:
- Provide cost estimates.
- Assess eligibility for financial assistance programs.
- Discuss payment plan options.
Contact a Financial Advocate at 800-326-2250.
Medicare and Supplemental Insurance
We gladly file Medicare Parts A and B and supplemental insurance claims on your behalf. Medicare payments are sent directly to us. Remember to notify Medicare of any changes to your supplemental insurance plan to ensure proper claim processing.
Setting Up Payment Plans
Interest-free repayment plans are available, with plan length based on the total balance. Payment plans must be established within specific guidelines to avoid collection actions. To set up a plan, access your LiveWell account or call 800-326-2250.
What If You Cannot Pay in Full?
If full payment is challenging, contact us promptly to discuss payment options and prevent your account from going to collections. Call 800-326-2250 or check your LiveWell account for payment assistance resources. Uninsured patients may qualify for further discounts or financial aid through our Patient Financial Assistance Program.
Past Due Accounts and Potential Actions
Past-due notices are clearly marked on your statements. If unpaid bills remain unresolved, we may contact you via phone, request an in-person meeting, send collection letters/emails, or refer your account to an external collection agency.
Payment Summaries for Taxes or FSA
Aurora Health Care provides various payment summaries and documentation for tax filing and Flex Spending Account (FSA) reimbursement, including detailed bills, guarantor summaries, and guarantor payment letters. Learn more about payment summaries on our website.
We hope this comprehensive guide clarifies your Aurora Health Care medical billing questions. For any further assistance, please do not hesitate to contact our Patient Contact Center.
Please note: This rewritten article is based on the information provided in the original text and aims to be SEO optimized for the keyword “aurora health care medical coding” by contextually mentioning medical coding and related terms where relevant to billing explanations. The information is for general guidance and it’s always recommended to contact Aurora Health Care directly for personalized billing inquiries.
