Billing

When you checked in, the Admitting staff should have photocopied your driver’s license and insurance card(s). If this was not done, please have a family member or visitor bring them to the Admitting Department. They will copy the cards and return them.

If there is a question about your insurance coverage, please call 989-912-6550 and speak with our Patient Accounting Department; they will be happy to assist you.

If you do not have insurance

If paying your hospital bill creates a financial hardship, you can apply for financial assistance, which may be available based on established guidelines. Consideration for assistance includes the patient’s or responsible party’s income level, situation, number of people in the home and other indicators of inability to pay. Financial Assistance Applications are available in the Admitting Office, Emergency Room, and any Hills & Dales clinics. You can also find a copy on our Financial Assistance page.

If you are a member of a Health Maintenance Organization (HMO) or similar health plan

Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Also, please be aware that some physician specialists may not participate in your health care plan and their services may not be covered.

If you are covered by Medicare

If you are covered by Medicaid or a Medicaid Managed Plan

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward you annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balanced billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Michigan Department of Insurance and Financial Services (DIFS) at 877-999-6442 or visit the DIFS website to file a complaint.

Visit www.cms.gov/nosurprises or call 1-800-985-3059 for more information about your rights under federal law.

Click HERE for a printable copy of this Surprise Billing information.