About the Billing Process

Preparing for your visit:

Step 1: Before service or admission, be familiar with your insurance

If you are covered by insurance, it is always a good idea to be familiar with your insurance plan and/or contact your insurance carrier before coming to the hospital. Understanding your referral, authorization and financial requirements will help avoid any potential delays or issues. Find out if your policy or plan requires a pre-authorization or referral. If so, contact your insurance company and find out what you need to do to obtain one. 

Reminder: Medicare and Medicaid require written orders for all exams.

Step 2: Bring the following to your appointment

Come to your appointment at UP Health System with your:

• Insurance card
• Name and address of your plan or insurer(s)
• Name and address of your claims payer (if different from insurer)
• Your ID and group numbers
• Name of the policyholder or subscriber

If applicable, for workers’ compensation, automobile, or personal injury cases, we require the name and address of your attorney, as well.

Our medical billing process—here's how it works:

If you have insurance, we submit a claim for payment, and any secondary claims, to the insurance company(ies) under the benefit coverage you specify, including workers’ compensation, auto insurance and personal injury.

Uninsured

If you are uninsured (self-pay), you will be sent an itemized bill requesting payment in full within 30 days of your discharge and subsequent monthly statements and/or letters indicating your new balance after payments or adjustments.

Insured

Once your insurance company has made payment, we will send you a balance statement for any amount your insurance did not cover. Subsequent monthly statements and/or letters will be sent to you indicating your new balance after any payments or adjustments.

Ultimately, you are responsible for payment of the account. Please contact your insurance company if it has not paid for your service or procedure after 30 days.

You can contact your insurance company by:

• Calling a number that may be on the back of your insurance card
• Visiting your insurance company's website
• Talk to someone in your employer's human resources department

Financial Assistance

If you do not have insurance, please visit or call the Business Services department at 906.449.1422. We have payment plans and financial assistance options, and our financial counselors will work with you to determine if you are eligible for financial assistance or self-pay discounts.

Statements

UP Health System bills for its employed physician services separately from its hospital services. Therefore, most patients will receive at least two bills from UP Health System: one for hospital (facility) services and one for hospital-employed physician services. You also may receive other bills from non-UP Health System staff that are related to your stay at the hospital (for example, radiology services). 

Understanding Your Bill

The first step to understanding your UP Health System bills is to realize there are two types of bills you may receive from us. We send bills for physician services, which include office visits. And we send bills for hospital services, which include laboratory fees, inpatient stays, emergency room visits, etc.

Example Bill - Physician Practices
Example Bill - Hospital

Organizing Your Bills

Organizing medical bills and statements can be challenging. To help, we have put together a list of tips that you may find helpful in creating a system for managing these important documents.

After a hospital stay or a visit to your doctor, you may receive different types of documents, such as bills, account statements, medical insurance claim forms and prescription information. It is important to keep these together and in order. To start, it is helpful to get a large notebook with dividers and pockets. Several plain folders or an accordion file will also work.

Label the pockets or individual folders for the following:

• Each provider of service (your physician, hospital, clinic, etc.)
• Prescription information
• Extra insurance forms
• Miscellaneous

Review statements carefully

Make sure you understand the bills and statements you receive. If you have any questions, call the number on the bill or statement for clarification. Ask for an itemized statement from the Billing Department to help you understand the list of charges if one is not provided.

Review the information looking for:

• Name of the provider
• Address of the provider
• Your account number
• Date of service and associated charges
• Description of service
• Your name, and insurance information including Medicare
• Phone number to call with questions

Explanation of Benefits (EOB)

If you have health care insurance, you can expect to receive an explanation of benefits (EOB) from your insurer. This will state whether a charge was paid, or denied or if additional information is needed. Sort the EOBs you receive by the provider of service and the total amount charged. Provider names will appear as that of your hospital, physician’s office, lab, etc.

Separate the bills you receive by the name of the provider. Look for the service date (the date you had the test or procedure or the date of your doctor’s office visit) and the total amount of the charge as you sort and organize documents related to each provider.

Next, match the provider statement with the insurance payment statements (EOB forms).

Take the provider bill and look for the service date and the amount of the charge. Next, look at the insurance EOBs you have received, and then the supplemental EOBs (if you are covered under more than one insurance plan).

Clip them together in this order:

1. Place the provider bill on top
2. Then attach the insurance payment statement (EOB)
3. Lastly, attach the supplemental EOB form, if applicable

Proceed with the rest of the provider bills, following the same procedure. Place any duplicates in a separate stack to be discarded.

Supplemental Insurance

If your primary insurance has paid on the claim, then any supplemental insurance you have can be billed. If the service provider is billing insurance for you, then simply file the insurance payment form in the correct provider folder or divider as your record.

However, if you must submit the claim with your secondary insurance, it’s important to make a photocopy of the EOB form and the provider bill. Write on the copies your supplemental identification number, then mail both the EOB form and the itemized bill to the insurance company. Please note: Some insurance companies require their claim form also be included. Follow your insurance company’s procedures.

When each provider charge has been paid by your insurance, and there is no remaining balance due, mark the bill as paid. File together the provider statement, the EOB form and the other insurance determination of benefits form in the proper folder or divider.

Keep Track of Payments

To keep track of all the payments, make a record of the information on a sheet of paper for easy review.

Make a list of the following:

• Provider of service
• Account number
• Date of service
• Total charge for service
• Amount paid by insurance if applicable
• Amount paid by you
• Current balance