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Billing FAQs

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Can I apply for financial assistance before I actually receive services?
Yes, a financial counselor can determine whether you are eligible for assistance and begin the application process before any services are provided.

 

What constitutes a household income?
Guidelines for household incomes can vary between state and federal guidelines. Our financial counselors can share this information with you.

 

Which financial assistance program should I apply for?
Our financial counselors may suggest you apply for several programs at once so if one application is delayed or denied, other options are still in progress.

 

What can I do if I cannot pay the entire balance on my hospital bill at once?
We can help determine whether you qualify for assistance or set you up on a payment plan.

 

Will I receive an itemized statement for the services rendered at the medical center?
Patients who come to the medical center without insurance receive an itemized statement as the first bill. Patients who receive bills after insurance consideration do not receive an itemized bill.

You can request an itemized statement at any time by calling the Business Office toll free at (877) 255-4680 or at (207) 872-4680 and selecting option 1.

 

Can I come in and talk to someone about my bill?
Yes. Our patient financial representatives will be glad to help you with billing questions from 8 a.m. to 4:30 p.m., Monday - Friday. Our office is located at the Seton Campus, 30 Chase Avenue, Waterville (2nd floor).

 

I received a bill from Waterville, but never had services there. Why?
The Business Office is located in Waterville and serves the Augusta and Waterville medical centers, the Family Medicine Institute, Maine Dartmouth Family Practice, Four Seasons Family Practice and Jackman Region Health Center.

 

 

I come to the hospital often. Can I just receive one bill?
Unfortunately, because of insurance requirements, we may be required to send a bill for each visit separately.

 

 

Why did I receive separate bills for the hospital and doctor(s)? 
The bills from the doctor(s) are for the professional services medical staff provided in diagnosing and interpreting test results while you were a patient in the hospital.

Pathologists, radiologists, cardiologists and other specialists perform these services and are legally required to submit separate bills. If you have questions about these bills, please call the number printed on the statement you received.

 

Why do I need to call the insurance company if they do not pay the bill?
You are ultimately responsible for any part of the bill your insurance carrier doesn't pay.

We will make every effort to resolve the account balance with your insurance carrier. Ir we are unable to resolve the issue, we may need your help.

 

Will you bill my primary and secondary insurance?
As a courtesy to our patients, we submit bills to your insurance company. Please be sure to give us complete primary insurance information. 

We will also do everything possible to advance your claim.  Your insurance company will let you or us know if they need more information to process your claim or to speed up payment.

 

Why did my insurance company only pay part of my bill?
Most insurance plans require you to pay a deductible and/or co-insurance. You also could be responsible for non-covered services. Please contact your insurance company for more information

 

I belong to a managed care plan. What should I do before coming to the hospital?
Failing to follow your plan requirements may result in greater out-of-pocket expenses for you. Your primary care physician plays a very important role in this process.

Read your insurance plan booklet to be sure you've followed all the guidelines for referrals and authorizations, or call your managed care company for help.

If you receive a verbal authorization number, please provide us with this information when you register.

 

I belong to a managed care plan but needed to be seen in the emergency room. What should I do?
If you did not contact your primary care physician or your insurance plan before you came to the emergency room, you must contact them within 24 hours to explain the circumstances and ask for authorization.

 

Are itemized bills automatically sent to patients?
No. We send summary statements to patients but are happy to provide itemized bills upon request. To request one, please call the Business Office at (207) 872-4680 or toll-free (877) 255-4680.

 

Can I pay my bill online using my computer?
Yes. Use our secure Online Bill Payment Service to make payments on your bill.

 

Do you offer payment arrangements?
Yes, payment arrangements may be made by calling the Business Office at (207) 872-4680 or toll-free (877) 255-4680.

 

I don't have any insurance. Is there any help available?
Yes. We have financial counselors who will help you apply for Medicaid or advise you on how to proceed.

If you do not qualify for any government programs, we can review your financial status to see if you qualify for local grant programs or Uncompensated Care (free or reduced bills).

 

Can I come in and talk to someone about financial assistance?
Yes, our financial counselors are conveniently located at the Alfond Center Health in Augusta, the Thayer Center for Health in Waterville and MaineGeneral's Seton Campus, also located in Waterville.

To ensure a financial counselor is readily available when you arrive, we suggest you schedule an appointment at (207) 861-5240 or toll free (888) 849-6055.

 

Why do I have to register each time I come to the hospital?
Information gathered from you at registration is stored in our computer system. We retrieve this information each time you return for services and ask you to confirm that the information is current and accurate.

Most check-ins are quick with only five things checked:

  • Your name and date of birth (to be sure we have the right record)
  • Your preferred phone
  • The insurance you want us to bill for this visit
  • The provider ordering the test
  • The reason for the visit.


If you have an appointment, the provider and reason for the visit will already be collected. We routinely re-validate other information every six months. You can also go online to check your information for accuracy at any time by using our patient portal. 

For Medicare beneficiaries, Medicare requires that specific questions be asked on every visit  to determine whether Medicare or another payer is primary.
 
For people with no changes to their demographics or insurance, our kiosk offers a “self-service” check-in.  Kiosks are located in the Thayer lobby and at the Alfond Center for Health.  
 
Accurate information is important to ensure your health care providers can contact you, and that you receive the insurance coverage you deserve. Your help in verifying the information is always appreciated.
 

Please click here for our online registration option.

 

What is a co-payment?
It is a set fee a member pays to providers when services are provided. Co-payments are applied to emergency department visits, hospital admissions, office visits, etc. The costs are usually minimal.
Patients should be aware of the co-payment amounts before receiving services.

 

What is a deductible?
Deductibles require the member to accumulate a specific amount of medical bills before benefits are paid by insurance.

For example, if a member's policy contains a $500 deductible, the member must accumulate and pay $500 in medical expenses, using his/her own money out of pocket, before the insurance carrier will pay benefits.

Once the patient has met his/her deductible, the carrier usually pays a percentage of the bill. The patient is responsible for paying the unpaid percentage.

Deductibles are yearly, usually starting in January.

 

What is co-insurance?
Co-insurance is a form of cost-sharing. After your deductible has been met, your insurance plan will begin paying a percentage of your bills.

The remaining amount, known as co-insurance, is the portion due to be paid by the patient.

 

How will MaineGeneral know which health plan I participate in?
Please present your current health plan identification card when you register for inpatient or outpatient services at the Alfond Center for Health, the Thayer Center for Health, Jackman Region Health Center or any of our physician office locations.

 

What is the difference between an HMO and a PPO?
Health Maintenance Organizations (HMOs) require a patient to select a primary care physician (PCP) to coordinate his or her care.

Most HMOs provide care through a network of hospitals, doctors and other medical professionals patients must use to be covered for that service.

Preferred Provider Organizations (PPOs) provide care through a network of hospitals, doctors and other medical professionals.

When patients use health care providers within the network, they receive a higher benefit and pay less money out of their pocket.

Services received by a non-participating hospital or doctor may still be covered, but often at a reduced benefit level.

 

What do "in-network" and "out-of-network" mean?
If you receive health care services from a hospital, physician or other health care provider that participates in your health plan, they are often referred to as "in-network."

Hospitals, physicians or other health care providers who do not participate in your health plan may be referred to as "out-of-network."

 

How do I know if my health plan requires a referral or pre-certification for a service?
Your benefit book or provider directory should provide this for you. If not, call the customer service phone number listed on your insurance card.

 

How do I know if my health plan includes MaineGeneral Medical Center?
MaineGeneral participates in most major health plans. Please review your health plan provider directory and/or consult with your health plan to confirm coverage.