Billing Process at Meadville Medical Center
During the admissions and registration process at Meadville Medical Center (MMC), you will be asked questions about your current insurance. Please bring along any necessary insurance information, such as enrollment cards. Your insurance cards are important because they let us know if there is a need for a pre-certification or if a co-payment is part of your plan. They also provide us with the insurance numbers and addresses for billing. The business office will bill both primary and secondary insurance companies for all inpatient and outpatient services. If you have more than one form of insurance, please let us know. You will be asked for a driver’s license or photo ID to verify your identity. Please bring either one with you so that the registration clerk may copy or verify your personal information.
Most patients have some type of health insurance to help pay their hospital bill. However, very few health insurance programs pay the entire bill. The following guidelines may assist you in settling your account. If you have questions regarding your insurance coverage or your bill, contact our Business Office.
Blue Cross & Medicare
Both are billed directly by the hospital Business Office. Payment is made directly to the hospital. Any balance due will be payable as indicated under SELF-PAY.
Both group and individual insurances are billed directly by the hospital Business Office. It is required that you sign an authorization to pay insurance benefits directly to the hospital. Unless the account is paid in full, the balance due will be payable as indicated under SELF-PAY.
It is required that you present your current active medical card at the time of admission to the hospital. Otherwise your account will be payable as indicated under SELF-PAY.
All balances due are payable in full at the time of discharge.
Financial Assistance Program
Many patients qualify for a reduction in fees owed if financial need is proven. If an individual is unable to make monthly payments and feels he or she could qualify for this benefit, then he or she should contact any Financial Counselor to discuss options. A Financial Counselor is available Monday-Friday, 7:00 am – 3:30 pm.
Please ask if you or your insurance carrier requires an itemized bill for services rendered at MMC. If you are requesting a bill on behalf of a patient, but do not hold the power of attorney for the patient, the patient must sign a “Release of Medical Records” to do so. If you hold the power of attorney for a patient, you must sign the release and provide legal documentation showing proof of power of attorney.
Radiology & Surgery
If you have an X-ray while in the hospital, you will receive a separate bill from Meadville Diagnostic Medical Imaging, Inc. This company is the group of physicians who view and read the X-rays. If you have surgery, you will also receive a separate bill from your surgeon and the physician who administers your anesthesia.
If you request a private room upon admission to the medical center, or if you request a transfer to a private room during your stay, you will be asked to sign our Private Room Authorization form. There will be an additional room charge for each day you stay in the private room. At the time of discharge from the hospital, you will be required to pay in full the charges for the number of days you occupied a private room.
Emergency Department Physicians
If a physician other than your primary care physician examined you in the Emergency Department, you will receive a bill from that physician or designated parties for services performed.
At Meadville Medical Center (MMC), we understand that Medicare can be confusing. This page contains answers to a few of the questions we most frequently receive from our patients regarding Medicare. Give us a call if you would like to learn more or if you have further questions. Our Meadville hospital staff is here to help you.
The following preventative services are covered under Medicare Part B:
- Bone Mass Measurements – For certain people at high risk for losing bone mass
- Colorectal Cancer Screening tests (such as Fecal Occult Blood Test) – Once every 12 months for people with Medicare age 50 and older
- Diabetes Self Management Services – Blood glucose monitors, test strips and lancets, and self-management training
- Glaucoma Screening – For high-risk patients, those with a family history of glaucoma, and those with diabetes
- Mammography Screening – Once every 12 months for women with Medicare age 40 and over. You are responsible for 20% of the Medicare-approved amount with no Part B deductible.
- Medical Nutritional Therapy services – For patients with diabetes or renal disease
- Pap Smear & Pelvic Examination – Once every 36 months; once every 12 months if you are at high risk for cervical or vaginal cancer for all women with Medicare
Prostate Cancer Screening – Once every 12 months for all men with Medicare age 50 and older. You are responsible for 20% of the Medicare-approved amount for the digital rectal exam after the yearly Part B deductible.
The following vaccinations are also covered under Medicare Part B:
- Flu Shot – Once a year in the fall or winter for all people with Medicare
- Pneumonia Shot – One shot may be all you ever need; ask your doctor
- Hepatitis B Shot – If you are at medium to high risk for hepatitis; you will be responsible for 20% of the Medicare-approved amount after the yearly Part B deductible
What services does Original Medicare Plan Part A and Part B not cover?
The Original Medicare Plan does not cover everything. Your out-of-pocket costs for healthcare will include, but are not limited to:
- Deductibles, coinsurance or copayments when you get healthcare services
- Dental care and dentures, in most cases
- Cosmetic surgery, except after an accident
- Custodial care at home or in a nursing home
- Hearing aids
- Orthopedic shoes
- Outpatient prescription drugs, with only a few exceptions
- Routine foot care and orthopedic shoes, except for diabetics
- Routine eye care, glasses, hearing aids
- Routine or yearly physical exams
- Services not reasonable or medically necessary
What is Medicare Part A and Part B?
Medicare Part A helps pay for care in hospitals as an inpatient, skilled nursing facilities, hospice care and some home healthcare. Most people get Part A automatically when they turn age 65. They do not have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working.
Medicare Part B helps pay for doctors’ services, outpatient hospital care and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for those covered services and supplies when they are medically necessary. You pay the Medicare Part B premium of $58.70 per month. In some cases this amount may be higher if you did not choose Part B when you first became eligible at age 65.
Use the following contact information to learn more about Medicare:
- Questions regarding Medicare Part A – Call 800-853-1419
- Questions regarding Medicare Part B – Call 800-746-5680
- Questions about Medicare Managed Care Plans – Call 800-633-4227
- Questions about Social Security Administration (SSA) – Call 800-772-1213 or http://www.ssa.gov/
- Visit the Medicare Web Site – http://www.medicare.gov/
Navigator with the Health Insurance Marketplace
Lisa Cox is a trained Insurance Navigator who is able to assist consumers in their search for health coverage options that will help pay their medical bills through the Health Insurance Marketplace, Compass, and Medicaid. Services are free to consumers.
Contact Patient Financial Services at MMC
For more information or for answers to your questions, please contact us using the information below:
Customer Service – 888-219-6117
Revenue Cycle Director – 814-333-5766