Billing Questions


My Bill

Healthcare billing can be confusing, so at Upland Hills Health we work with patients in a positive and proactive way to help settle accounts in the most timely and convenient manner. And our expertise with insurance plans and payments means our patients find the best solutions.

Frequently Asked Questions


 

Will Upland Hills Health file my insurance claim(s)?

Yes, as a courtesy, we will submit a claim to your insurance. We do not guarantee payment by your insurance company. It is important that you provide accurate and complete insurance information at the time of registration. It is your responsibility to provide any requested information to your insurance company (accident information, claim forms, other health information or pre-existing condition information).

We also submit secondary claims on your behalf. Secondary claims are only submitted after your primary claims have completed processing.

Will I receive an itemized statement?

If you wish to receive an itemized statement, please call our Patient Benefit Specialist team at 608.930.7200 ext. 4145.

What if I cannot pay my bill in full after insurance processes my claim?

Payment of your bill is due within 30 days of the patient balance appearing on your statement. However, our Patient Benefit Specialist team can work with you to arrange a reasonable payment plan. Please call our Patient Benefit Specialist team at 608.930.7200 ext. 4145.

I don't have insurance. Is there any help available?

For assistance, please contact our Patient Benefit Specialist team at 608.930.7200 ext. 4145. They will assist you with information on programs that may be available to you or will give you advice about how to proceed. If you do not qualify for any type of government programs, we can review your financial status to see if you qualify for Uncompensated Care.

Can I find out how much a medical service will cost?

If you would like to request a price estimate, please contact our Patient Benefit Specialist team at 608.930.7200 ext. 4145. 

In order to provide you with an accurate estimate of services, you should obtain information from your physician about the procedure that has been ordered.

Please note you will be given an average cost or a price range rather than a specific estimate. The final charges are based on a variety of factors related to the clinical services provided.

How will I know if my insurance company has paid my bill?

If there is a balance due from you after the insurance company has paid its portion, we will send you a statement. This statement indicates the amount that has been paid and any balance you are required to pay. This is your bill, which you are required to pay in full or set up payment arrangements by contacting our Patient Benefit Specialist team at 608.930.7200 ext. 4145.

How do I know if my insurance company will cover my visit or certain services?

Coverage varies with each insurance company. Please refer to your insurance member handbook or call your insurance company with questions. Medically necessary and appropriate services may not always be covered by your insurance contract. 

Why am I receiving a bill for services authorized by or covered by my insurance?

Your insurance plan is a cost-sharing agreement between you and your insurance company. An insurance authorization is not a guarantee of payment. Generally, many insurance companies cover the costs for preventative care throughout the year, such as check-ups, vaccinations, etc.

For other services, insurance companies may require you to cover all the costs until you reach a specified amount, known as a deductible. Once you reach that specific amount, then the insurance company starts paying for covered services.

If you believe your insurance should be paying on your services, or if you have other questions about your insurance coverage, you should contact your insurance company directly.

What should I do if I disagree with how much my insurance company has paid on my bill?

If you have questions regarding payment, call your insurance company for an explanation of payment. If the insurance company finds that an error was made, note the information and whom you talked to at the insurance company. Request an anticipated payment date and ask if they need any further information to complete processing. If the insurance company feels the bill was paid correctly and you still disagree, find out from the insurance company what you need to do to file an appeal with them. Filing an appeal will not guarantee more will be paid on your bill, but the claim will be reviewed for reconsideration.

Why is this billed as an outpatient service when I spent the night in the hospital?
  • You are an inpatient when the hospital formally admits you with a doctor’s order.
  • You are an outpatient if you are getting emergency or observation services (which may include an overnight stay in the hospital or services in an outpatient clinic), lab tests, or x-rays or imaging tests, without a formal inpatient admission.

For an account to be billed as an inpatient service, there must be a physician order and, if you use Medicare insurance, specific Medicare requirements must be met. The physician who ordered your services determined that your condition did not meet Medicare’s requirements for an inpatient admission. The physician’s written order dictates whether we bill as an inpatient or outpatient.

I received care at Upland Hills Health and received several bills. Why don't you put all of the charges on one bill?

Upland Hills Health’s statements reflect hospital charges and Upland Hills Health physician charges. Radiologist and pathologists will bill separately for their services (they are not Upland Hills Health physicians). Should you have any question concerning their bills, please contact them directly. If you receive a billing statement and have not visited us as a patient, this bill may be for lab specimens sent to us by your physician.

Why do I have more than one account number?

Each time you receive services from Upland Hills Health–inpatient or outpatient services (such as physical therapy, medical imaging procedures, urgent care, emergency room care, clinic services, etc.), a separate account is created. It si possible to have multiple accounts open at the same time.

What do I need to pay for at the time of my appointment?

You are asked to come prepared to pay for all known patient expenses, such as co-payments, deductibles, co-insurance or non-covered amounts. If you are not able to pay in full at the time of service, our Patient Benefit Specialist team can help you arrange a reasonable payment plan.

Why do you need to scan my insurance card every year if nothing has changed?

We scan all patients’ insurance cards every year to ensure all of your personal and billing information in our records is up-to-date. This ensures your claims can be submitted in a timely and accurate manner.

Financial responsibility for all bills is with the patient or patient’s representative (guarantor). Because of this, if a patient’s insurance company does not make payment in a reasonable time frame and does not respond to attempts to resolve payment matters, the patient will be billed.

Upland Hills Health will attempt to provide your insurance company with all the information it needs, but there are times when they require information from the patient to resolve a claim.

Protection Against Surprise Billing

Common Insurance Definitions

If you have questions or concerns regarding your bill that are not answered here, or if you need help establishing a payment arrangement, our patient benefit specialists can help. They are available 8 am – 4:30 pm. You can reach a patient benefit specialist by calling 608.930.7200 ext. 4145.

 


Paying My Bill

Payment of deductibles, co-pays and non-covered services is due at the time of service. Upland Hills Health will then automatically file a claim with the patient’s insurance company for all covered services.

Acceptable payment methods include:

  • Personal or insurance check
  • Visa or MasterCard bank card
  • Pre-approved payment arrangement

Pay your bill through MyChart

A patient’s account is considered past due if:

  • Full payment is not received and no approved payment arrangements have been made
  • There is no response to requested information through letters and/or phone calls
  • Required application forms for hospital assistance (uncompensated care) programs have not been completed and returned

If you have questions or concerns regarding your bill or need help establishing a payment arrangement, our patient benefit specialists can help. They are available 8 am – 4:30 pm or by appointment. To set up a meeting, call 608.930.7200 ext. 4145.

 


Uncompensated Care – Sliding Fee Scale

Upland Hills Health offers programs to ensure that all members of the communities we serve are able to access medically-necessary* care, regardless of their ability to pay. Patients who meet financial requirements (based on family size and income) can receive help with their bills through discounts offered under these programs.

Medically-necessary services received in the clinic** setting are eligible for the Sliding Fee Scale Program. Upland Hills Health Clinic Mt. Horeb, Upland Hills Health Center and Upland Hills Health Hospital services that are considered medically-necessary are eligible for our Uncompensated Care Program.

How to Apply
Submit a completed application, along with all required supporting documents requested in the form.
Return to:
Upland Hills Health, Inc.
Attn: Patient Benefit Specialist
800 Compassion Way
Dodgeville, WI 53533

Discounts offered under these programs are made available without consideration of race, color, sex, national origin, disability, age, religion, sexual orientation or gender identity. For additional information, call: (608) 930-7200 extension 4145.

Additional Information:
*A medically-necessary service is defined as care that is non-elective and needed in order to prevent death or adverse effects to the patient’s health.
**Clinics disclaimer: Upland Hills Health Clinic in Spring Green, Highland, Montfort, Barneveld, Mineral Point Medical Center of Upland Hills Health and Dodgeville Medical Center of Upland Hills Health serves all patients regardless of the ability to pay. Services will not be denied due to the inability to pay. A sliding fee scale discount for medically-necessary services is offered based on family size and income.

Does my insurance work with Upland Hills Health?

It’s one of the most common questions our patient financial services experts get.

Most people are surprised to learn that Upland Hills Health works with a wide range of health plan and PPOs. We are an independent, nonprofit healthcare organization, always pursuing additional insurance carriers that service our communities.

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Most frequently used insurance plans:

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