Billing Frequently Asked Questions
Do I need a referral to see a UW Health provider?
Some insurance plans require the patient to obtain a referral from his/her primary care physician prior to seeing a UW Health physician or other provider. It is your responsibility to understand the provisions of your policy and to obtain a referral if one is necessary. If you are unsure about the provisions of your policy with respect to referrals, you should contact your insurance company's customer service department.
My UW provider has ordered a specific procedure or test. Do I need to receive authorization from my insurance company before I can have this procedure/test done?
Again, this varies by insurance plan. Please read your policy and/or check with your insurance company's customer service department if you are unsure as to whether prior authorization is necessary. When prior authorization is required, we will coordinate obtaining this authorization with you, as most insurers request specific clinical information from the provider before they will authorize the service.
My insurance plan requires a co-payment. Will I be required to pay the co-payment when I check-in for my appointment?
Copayments will be collected when you check-in. Payments can be made via cash, check or credit card.
I want to receive a service from a UW Health provider, but I know my insurance won't cover it. Is there a way I can find out how much the service will cost?
Yes. UW Health offers a service called Priceline. You may call (608) 263-1507 and ask for a price estimate. Please note that you will be given a price range, rather than a specific estimate, as the final charges are based on a variety of factors related to the clinical service provided, the diagnoses associated with those services, supplies used, etc. While it is possible to estimate these, it is not possible to precisely define these until after the service has been provided.
Does UW Health accept out-of-state Medical Assistance patients?
No. Most services are available to Medical Assistance patients within their home state. As a result, we do not accept out-of-state Medical Assistance patients if the services are available within their home state.
I am covered under an HMO or PPO. How can I find out if the UW Health provider I want to see is a participating provider under my plan?
There are numerous HMO and PPO plans, and provider networks associated with these plans change frequently. Please consult the provider directory given to you by your plan and/or call your insurance company's customer service department to obtain this information.
I would like to have some or all of the services associated with a visit treated confidentially so that they are not billed to my insurance. Is this possible?
Yes. We will establish a confidential account for you, upon request. Please note that all confidential accounts are treated as self-pay; you will be required to pay at the time of service for any services provided under a confidential account.
I'm covered under Medicare. Is there anything I should know about my coverage?
UW Health Physicians is a participating provider in the Medicare program and accepts assignment on all Medicare charges.
As a participating provider, we agree to accept the Medicare allowed amount as full payment for covered services. We will file all supplemental insurance claims. In addition, we handle most insurance payments, paperwork and correspondence.
Medicare pays 80 percent of the amounts allowed for covered services. Patients are responsible for the 20 percent copayment and the annual deductible. Patients are also responsible for any routine or preventive care not covered by Medicare. Some supplemental insurance policies may cover these costs.
I am unable to pay the full amount of my bill at this time. Is it possible to make payment arrangements?
Normally, payment of your bill is due within 15 days of the patient balance appearing on a statement. However, our financial advisors will work with you to arrange a payment plan if special circumstances prevent you from making a full, timely payment. Financial advisors are available Monday through Thursday, 8am to 8pm, Friday, 8am to 5pm, Saturday, 8am to 12pm, and can be contacted at 608-829-5254 or toll-free 877-565-8855.
Why did I receive two bills from UW Health?
Some UW Health patients may receive two bills for health care services, depending on where the services were provided.
- Facility bill: This bill is for the cost of services at a UW Hospital and Clinics facility, such as clinical staff, supplies and equipment.
- Professional services bill: This bill is for services provided by UW Health professionals, such as physicians, physicians assistants and nurse practitioners.
Will you file claims to my health insurance for my services?
UW Health Physicians files insurance claims, but the prompt full payment of the account remains the responsibility of the patient.
Though we may accept payment directly from an insurance company, any amount billed but not paid by insurance is the patient's obligation. Health insurance contracts are agreements between the insured and the insurance company. Please pay the remaining balance and contact your insurance company if you believe there is an error with the claim.