Medicare billing questions and answers

1. Do I have to sign any forms before you can bill Medicare?

At your clinic, you will need to sign one form that will be kept in your patient record. This form should cover all clinic visits.

If you are hospitalized or receive hospital services (outpatient procedures, etc.), you will be asked to sign a Medicare authorization form, even if you have been to one of our clinics and already completed a form.

2. Can I write one check for all my bills?

Please write a separate check for each bill you receive from Allina Hospitals & Clinics. You have been assigned separate accounts for clinic and hospital bills. Sending separate checks helps ensure that your accounts will be credited accurately.

3. I have other health insurance in addition to Medicare. Will you bill that insurance company also?

If you have given us information about your additional health insurance, we will bill that insurance company after Medicare has made its payment.

On its monthly summary notices, Medicare sometimes indicates that it submitted information to your secondary insurer. In those cases, Allina will not send a claim to your supplemental insurance company.

4. I saw a consulting physician specialist at one of your clinics. Will those charges be on my clinic bill?

No. If you receive care from a consulting physician specialist (a doctor who travels from another facility to see patients at the clinic), you will receive a bill from the physician's office, not from Allina Medical Clinic.

5. I was never admitted to the hospital. Why am I getting a hospital bill?

It is because you received hospital-based services, such as lab tests or X-rays, during a clinic visit. Government regulations require us to send a separate "hospital" bill for those services.

6. Should I pay the balance labeled "your total responsibility" on Part B of my Medicare statement?

No. This amount could change depending upon your insurance coverage. You should wait until you receive a bill from your medical provider before making any payment.

7. What if I get more than one bill?

Although Allina Hospitals & Clinics is one organization, we are required to bill patients separately for clinic services and hospital services.

• You will receive a hospital bill for hospital services or for any lab or X-ray (radiology) services you received at a hospital or clinic.
• You may receive another bill from a clinic for clinic services. Such bills are usually for services provided by clinic physicians.

8. What is a Medicare Summary Notice?

It is a document that Medicare sends after it has processed your medical claims to inform you about the payment status of your bill. The monthly statement replaces these letters: Explanation of Your Medicare Part B Benefits (EOMB), Medicare Benefit Notice (Part A), Explanation of Medicare Benefits (Part A) and Benefit Denial.

9. What is the difference between Part A and Part B of the Medicare Summary Notice?

The forms relate to the type of medical coverage you have. If you have Part A coverage, you'll receive the Part A form. If you have Part B coverage, you'll receive the Part B form.

Your Medicare card lists the type of coverage you have.

10. What should I do with the monthly statements I get from Medicare?

You should keep each statement or Medicare Summary Notice until all your medical claims have been paid in full.

If you have coverage in addition to Medicare, your insurance company may require a copy of the statement from you before they will pay any remaining balance on your account.

Allina does not receive copies of your Medicare Summary Notice. If you have not received the monthly statement, or have misplaced it, you can request a second copy.

• If you are a Minnesota resident and have Medicare Part A coverage, call (toll free) 1-800-330-5935.
• If you are a Minnesota resident and have Medicare Part B coverage, call 612-884-7171.
• If you are a resident of another state, call your state Medicare intermediary.

11. Whom can I contact with questions about my bill?

Please call 612-262-3990 or 1-800-276-2209 (if you are outside the Twin Cities metro area). Our customer service representatives can help you with any questions or concerns.

12. Why do I have to give you information about other insurance if I have Medicare coverage?

Medicare requires us to bill any insurance companies that could be responsible for your expenses before we bill Medicare. In fact, Medicare will not allow us to file claims until the other insurer has denied claims.

In certain situations, the medical center must consider the possibility that another party may be responsible for your expenses before we bill Medicare. For example, if you were injured in a car accident, at work, or on someone else's property, it is the medical center's responsibility to make sure related claims are filed appropriately. Consequently, we need to have complete information about all insurance coverage that you have.

13. Will I have to pay anything for my hospitalization or clinic visits?

As a Medicare patient, you will only be responsible for uncovered charges, co-payments and deductible amounts. These amounts may vary depending on your Medicare coverage.

We do not know what your payment may be until we receive the notification from Medicare. Once Medicare lets us know what your responsibility is, we will bill your Medicare supplemental insurance company for the balance. If you do not have supplemental coverage, you will be billed for the balance.

14. How can I learn more about Medicare?