Billing and insuranceHow to pay your bill

Our goal is to make the billing process as simple as possible for you.

Billing

Understanding your bill

How to pay your bill

To make the billing process simple and convenient, there are several ways you can pay your bill.

You can pay your bill online using MyChart.

If you have a UW Health MyChart account, you can set up payment plans and save credit card information for future payments. To pay your bill, log in to your MyChart account and under the billing icon, select "Billing Acct Summary" to see your billing information.

If you do not have a MyChart account, you can create a new account or pay as guest:

  • To request a new account, go to MyChart and select "Sign Up Now."

  • To pay as guest, go to MyChart and select "Pay as Guest." To pay as a guest, you will need your account number.

Login or sign up

You can pay your bill by phone.

To pay your bill through the mail, send your invoice with check or money order to:

  • If you received health care in Wisconsin:
    UW Health
    PO Box 78433
    Milwaukee, WI
    53278-8423

  • If you received health care in Illinois:
    UW Health
    PO Box 78627
    Milwaukee, WI
    53278-8423

You may pay your bill in person at any UW Health clinic registration or admissions desk.

  • If you received health care in Illinois, you may also pay in person, by appointment, at 2550 Charles Street, Rockford, Ill. To make an appointment, call (800) 305-8010.

Payment expectations

  • Out-of-pocket costs, copayment, co-insurance or deductible are due prior to outpatient services.

  • Payment of your full account balance is due 21 days after receiving your first bill. If you cannot pay in full, payment plans can be arranged through Patient Business Services.

Facility and telehealth site fees

When an outpatient clinic is owned and operated by one of our hospitals, that clinic is considered part of the hospital and UW Health is required to bill a facility fee along with any other charges that apply to that visit. This is called a facility fee and these clinics are sometimes referred to as “provider-based clinics." Even though you are not hospitalized, these facilities must meet strict patient safety standards and must follow regulatory requirements of the Centers for Medicare, Medicaid and The Joint Commission.

Patients who receive care in a hospital-owned clinic can expect to receive two bills: One for the facility fee and one for the provider care.

When care is received at a non-hospital clinic, all charges can be combined into one bill, so there is no facility fee.

Signs are posted in all clinics that require a facility fee or a telehealth fee. You can also refer to the billing practices brochure that is given to all new patients or contact our billing office with questions.

The following might have a facility or telehealth site fee:

Illinois locations

  • Ambulatory Rehab Pediatric Therapy Services and Sleep Disorders (209 Ninth St.)

  • Diabetes Self-Management Center (1415 E State St.)

  • Orthopedics and Sports Medicine (8451 Orth Road)

  • Regional Cancer Center (3535 N. Bell School Rd.)

  • Renaissance Pavilion Clinics (1340 Charles St.)

  • Stateline Physical Therapy (4282 E Rockton Rd.)

  • Stateline Lab, Radiology and Mammography (4282 E Rockton Rd.)

  • SwedishAmerican Hospital and Clinics (1401 E. State St.)

  • SwedishAmerican Medical Center – Belvidere (1625 S. State St.)

  • Women and Children’s Hospital and Clinics (1350 Charles St.)

  • Wound Care and Hyperbaric Clinic (1415 E. State St.)

Wisconsin locations

  • American Family Children's Hospital Clinics (1675 Highland Ave.)

  • American Family Children’s Hospital Clinics (2275 Deming Way)

  • Behavioral Health Youth and Family (122 E. Olin Ave.)

  • Digestive Health Center (750 University Row)

  • E Terrace Dr Medical Center (formerly East Clinic) (5249 E. Terrace Dr.)

  • East Madison Hospital (4602 Eastpark Blvd.)

  • Hand and Upper Extremity Rehabilitation Clinic (1 S. Park St.)

  • Junction Rd Medical Center (451 Junction Rd.)

  • Kidney Clinic (3034 Fish Hatchery Rd.)

  • Lymphedema and Venous Edema Clinic (1 S. Park St.)

  • Pain Management Clinic (1102 S. Park St.)

  • Science Dr Medical Center (formerly Research Park Clinic) (621 Science Dr.)

  • University Ave Rehabilitation Clinic (6630 University Ave.)

  • Union Corners Clinic Physical Therapy (2402 Winnebago St.)

  • University Hospital (600 Highland Ave.)

  • University Station Clinic (2880 University Ave.)

  • UW Carbone Cancer Center (600 Highland Ave.)

  • Waisman Center (1500 Highland Ave.)

    • Exception: Autism treatment programs

  • Women's Pelvic Wellness (202 S. Park St)

  • Yahara Clinic Orthopedic Physical Therapy (1050 East Broadway)

Frequently asked questions about facility and Telehealth site fees

While all are part of UW Health, each is required to follow billing regulatory requirements based on the type of facility where you receive your care.

Clinics that are owned and operated by UW Health physician groups — UW Medical Foundation, UW Department of Family Medicine and Community Health Clinics and SwedishAmerican Medical Group — charge patients a single fee that includes all the cost associated with running their practice.

Clinics that are hospital-owned are required to provide two separate bills.

Provider-based clinics are required to meet strict patient safety standards and more regulatory requirements than physician-owned clinics. One requirement is there must be two separate bills, one from the medical group for the doctor’s professional fees and the other from the hospital for all other costs. This second bill is referred to as the “facility fee.”

Facility fees represent all the costs of operating a building for health care delivery except the doctors’ professional fees. They cover the costs of equipment, utilities, maintenance, supplies and medications administered during a clinic visit. They also pay for care by non-physician staff such as nurses, pharmacists, social workers, medical assistants, respiratory therapists and dieticians.

Because hospital-owned clinics are required to meet strict patient safety standards and more regulatory requirements than physician-owned practices, facility fees also help to offset the cost of meeting these mandated requirements. Finally, fees also reflect some of the cost of training of physicians, nurses, pharmacists and other health care professionals.

UW Health charges a “Telehealth site fee” for virtual visits that would otherwise have occurred in person at any provider-based location listed above. This fee is based on the CMS guideline of billing a telehealth facility fee under the same circumstances as an in-person facility fee.  It covers the cost of additional technology and support services related to the visit.

Most insurers will cover facility fees and telehealth site fees, but some do not. Before your visit, call the customer service number listed on your insurance card to find out if your plan covers these fees billed by hospital-owned clinics.

UW Health charges a “telehealth site fee” for virtual visits that would otherwise have occurred in person at any provider-based location listed above. This fee is based on the CMS guideline of billing a telehealth facility fee under the same circumstances as an in-person facility fee. It covers the cost of additional technology and support services related to the visit.

Only facilities owned by UW Hospitals and Clinics and UW Health SwedishAmerican Hospital charge facility fees.

UW Health’s facility fee for an office visit is $220. UW Health’s telehealth site fee is $94.50. These fees are updated on a yearly basis.

No Surprises Act

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. For more information about your rights and protections against medical bills, please see this disclosure notice that explains surprise billing (sometimes called "balance billing") in more detail:

Frequently asked questions about billing

Yes. Our staff can assist you. In Wisconsin, call (877) 565-0505 and in Illinois call (800) 305-8010. You can also contact us through MyChart.

There are several ways to do this:

  • MyChart: Log in to your account and select the Billing > Insurance Summary option.

  • Phone: In Wisconsin, call (608) 261-1600 or (800) 303-6114. In Illinois, call (800) 305-8010.

  • Fax: Send a copy of your insurance card (front and back) to (608) 890-8531.

  • Mail: Send a copy of your insurance card (front and back) to Patient Business Services, 7974 UW Health Court, Middleton, WI 53562

UW Health will file a claim for services you received. Any amount that is billed but not paid by your insurance company, is your responsibility. If you feel the insurance company should pay a charge, please contact them directly.

Contact your insurance company. If they say they will be reprocessing your claim, please obtain a reference number and contact Customer Service:

Yes. We will establish a confidential account for you. Please note that confidential accounts are treated as self-pay and you will be required to pay at the time of service for any services.

Payment is still required when you are working with an attorney for TPL, Worker’s Compensation or other claims. Please contact Customer Service to arrange a payment plan.

Payment is still required when you are filing bankruptcy. If you have a bankruptcy case number or would like help setting up a payment arrangement, please contact Customer Service:

Pricing

Get an estimate for care

Price estimates

UW Health can provide a price estimate of what a procedure or treatment will cost, based on total charges for the same services, and how much you may be responsible for paying based on your insurance coverage. Please note that final charges may be different based on the actual services received and supplies used.

An estimate is the predicted amount your medical services will cost you. This includes information on what total charges have been in the past for this same service, as well as, what your personal out of pocket costs could be based on your insurance benefits.

Create your own estimate

You can create your own price estimate for common procedures and services. This feature is available for both MyChart and non-MyChart users.

Create an estimate through MyChart

MyChart users can create their own estimate for many common services. This will be linked to your patient record. To create an estimate:

  • Log into your MyChart account

  • Click on Billing

  • Select Estimates

Create a guest estimate

If you do not have a MyChart account, you can request an estimate for common procedures and services on as a guest. This estimate will not be linked to your patient record.

Make a guest estimate: Wisconsin | Illinois

UW Health proactively provides some estimates prior to services. You may receive this estimate via MyChart or in the US mail.

Other pricing options

For services in Wisconsin, if you are unable to create your own estimate via MyChart or Guest Estimate, you may call UW Health's Priceline team at (608) 263-1507 for assistance.

You will be given a price estimate or range, rather than a specific quote, as the final charges are based on a variety of factors related to the clinical service provided, the diagnoses associated with those services and supplies used. While it is possible to estimate these, it is not possible to precisely define these until after the service has been provided.

Pricing transparency

Beginning in 2022, health care providers were required to disclose, upon request, certain charge and payment information for health care services, tests and procedures.

About pricing transparency

UW Health believes generating an estimate will provide a better value in understanding your potential out-of-pocket expenses.

The Centers for Medicare and Medicaid Services (CMS) requires each hospital to post a list of their standard charges — a Charge Description Master (CDM) — in a machine-readable format and update the data at least annually. A standard charge means the regular rate established by the hospital for an item or service provided to a specific group of paying patients.

For purposes of complying with the Hospital Price Transparency Final Rule, this includes five types of standard charges: gross charge, discounted cash price, payor-specific negotiated charge, de-identified minimum negotiated charge, and de-identified maximum negotiated charge. CMS intended that this information would help patients with improved information regarding price transparency.

The CDM and the corresponding standard charges themselves may not provide the appropriate price transparency for the patient as a patient’s out-of-pocket cost is not determined by the standard charges of a hospital alone. The out-of-pocket cost is driven primarily by:

  • Any copay, deductible, and/or coinsurance required by the patient’s benefit plan; and

  • The negotiated charge that the patient’s insurance carrier will pay the hospital, which is generally less than the standard charges.

  • Any patient that is uninsured will pay the discounted cash price.

If you still wish to review the CDM, please understand the following:

  • The descriptions in the CDM may not be understandable to the layperson.

  • The inpatient total charge amount and reimbursement rates for many procedures is made up of many individual charge items from the CDM.

  • Due to variations in individual physician practice patterns, as well as individual patient differences and the potential for unforeseen complications, charges may vary based on the patient’s situation. Payer specific negotiated charges are sometimes not at the charge master item level and therefore we are unable to provide these amounts at this level of detail.

Note: When you click the links below for standard charges, the file(s) will download to your computer or mobile device.

View the standard charge listing for UW Health University Hospital, American Family Children’s Hospital and UW Health East Madison Hospital: Standard charges (xlsx)

View the standard charge listing for UW Health SwedishAmerican Hospital: Standard charges (xlsx)

Additional resources

HealthCare Financial Management Consumer Guide

Financial counseling

Helping you plan

UW Health is committed to providing financial counseling assistance to help our patients and families develop a plan to ease financial hardships and stress due to planned and unplanned medical bills.

Our financial counselors can help you understand your insurance coverage and benefits, answer questions related to the cost of healthcare services and provide options on how you can pay your current and future medical bills. Patient financial resources (pdf)

To help us provide the best possible service to you, we encourage you to contact us as early as possible — before services are provided and costs are incurred.

For assistance, call (877) 278-6437 in Wisconsin or (800) 305-8010 in Illinois.

Financial counseling services 

  • Creating estimates for upcoming services | Get an estimate

  • Education on insurance terms and benefits (copayments, deductibles, networks, etc.)

  • Developing a financial plan for satisfying current and future bills

  • Setting up payment plans

  • Linking patients to potential insurance options, such as Medicaid, Medicare or the healthcare insurance marketplace

  • Identifying eligibility for UW Health’s Financial Assistance Program

Frequently asked questions

Yes. UW Health does provide care to patients without insurance. You may be asked to pre-pay for services or receive a bill shortly after requesting payment in full.

UW Health partners with Elevate Patient Financial Solutions to assist patients who may qualify for governmental financial assistance. Elevate Patient Financial Solutions will serve as a patient advocate and is committed to working with you to get the benefits that are needed. Contact Elevate Patient Financial Solutions by calling (608) 265-1705.

Health insurance can be purchased through the Health Insurance Marketplace. UW Health also partners with United Way of Dane County to fund HealthConnect, which helps lower-income Dane County residents with their healthcare premiums through the Marketplace.

Financial Assistance Program

Help when you need it

UW Health offers a financial assistance program to help people who are unable to pay for their medical services they receive.

Patient’s may be able to get financial help if they are not insured, underinsured, do not qualify for government assistance (for example Medicare or Medicaid) or it is hard to pay for care at UW Health.

How do I apply for financial assistance?

You can apply for financial assistance in the following ways:

Financial assistance policy and forms

Who may be eligible to receive financial assistance

The following guidelines help identify patients who may be eligible to receive financial assistance:

  • The care is medically necessary

  • UW Health is the appropriate provider for the level of care required by the patient

  • Patient is unable to get county, state or federal aid for medical care

  • Patient lives in UW Health’s primary service community, or UW Health is the closest facility to the patient's home that provides the sub-specialty care required

  • Patient's family income is at or below 600 percent of the federal poverty level or patient has medical bills that add up to at least half of their yearly income. These patients will qualify for a reduction in their bills based on a sliding scale.

HealthConnect for Wisconsin patients

UW Health partners with United Way of Dane County to fund HealthConnect which helps lower-income Dane County residents with their health care premiums through the Marketplace.

Learn more about UW Health and the Affordable Care Act

About health insurance

Understanding your health insurance

UW Health is committed to providing remarkable care and service to our patients and families. This includes helping you understand what health insurance is, what prior authorization means and how to understand some common health insurance terms.

Health insurance is a contract between you and your health insurer to cover your medical expenses. Your health insurance company helps pay for some or all of your medical care, depending on the type of insurance plan you have. If you have questions about your coverage, we also encourage you to check with your insurance company.

Prior authorization and non-covered benefits

Your doctor will decide which procedures, tests, and other consultations you may need. However, many health plans require referrals, prior authorization, and/or sometimes predetermination of medical necessity prior to care being provided to cover your service(s).

Examples of services that may require authorization include surgeries, planned admissions, therapy, and advanced imaging procedures such as CT, MRI, and PET scans. Beyond prior authorization, some services may not be a covered benefit under your plan all together. These services are considered an “excluded benefit” under your plan.

The UW Health Financial Clearance team will work with your insurance company to obtain your necessary prior authorization(s). How early we start your authorization will vary depending on the service you are receiving. However, you can assume we will start your authorization 3-6 weeks before your date of service. Be aware that investigating coverage requirements, limits, and obtaining authorization from your insurance carrier, especially for complex or investigational surgeries, can take up to six weeks. We will only notify you if there is an issue with your approval. If you are questioning if your insurance has authorized your upcoming service, reach out to your health insurance’s member services department.

What you need to know

You are responsible for knowing your:

  • Health insurance network (i.e., what locations are in-network versus out-of-network)

    • Managed care plans such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs) may deny or reduce benefits if care is obtained outside of the established “in-network” locations

    • To go to an “out-of-network” location and have your health insurance pay, you may need a referral or gap exemption from your health insurance.

    • Check with your health insurance member services department to find out if UW Health is considered an in-network facility for the services you are seeking.

  • Authorization and precertification requirements

    • Insurance plans that require prior authorization or pre-certification may not pay for services if it is not authorized prior to the date of service. In such cases, you may be financially responsible for the provided services.

    • If there are any issues with your insurance authorization, the UW Health Financial Clearance Department will work with your provider to determine medical urgency, and we will then contact you. At that time, you may be given options on proceeding with your service, pre-paying, or rescheduling.

  • Noncovered benefits under your health plan.

    • Your health insurance likely has certain services that it does not cover (examples may include acupuncture, fertility care, etc.). You are responsible for knowing if your insurance does not cover certain types of services.

    • You are financially responsible for services not covered under your health insurance benefits.

UW Health highly recommends that you contact your insurance company to determine your specific benefits for the UW Health location at which you plan to be seen.

Common insurance terms

When you are trying to manage your health insurance, you may hear many different terms. Below are some of the common terms you may encounter. For a printable version, see our brochure Understanding your health insurance (pdf)

In-network refers to select groups of doctors, hospitals and other healthcare professionals who are contracted with your insurance to provide a full range of covered healthcare services. If you visit a doctor outside of your network, you might have to pay more for your care. In some cases, you may have to pay the full cost.

Contact your insurance company to find out which providers are “in-network.” These providers may also be called “preferred providers” or “participating providers.”

Allowed amount is the amount that your health insurance will pay for a particular service. The allowed amount can be different for in-network as opposed to out-of-network providers and facilities.

Premium is the amount that must be paid for your health insurance. You and/or your employer usually pay it monthly, quarterly, or yearly. It is not included in your deductible, your copayment, or your co-insurance. If you don’t pay your premium, you could lose your coverage.

Deductible is the amount you owe for healthcare services your health insurance or plan covers before your health insurance begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve paid the first $1,000 toward your healthcare services. The deductible may not apply to all services. You will want to check with your insurance company for any exclusions.

Co-insurance is your share of the costs of a covered healthcare service, calculated as a percent (for example, 20 percent) of the total cost for the service. You pay co-insurance after you have met your deductible. If your health insurance allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20 percent would be $20. Your health insurance pays the rest of the allowed amount.

Copayment, or copay, is an amount you are required to pay as your share of the cost for a medical service, like a doctor’s visit or prescription drug. A copay is usually a fixed amount, rather than a percentage. Copayments might be different depending on the type of service you receive; a copayment for a visit to an emergency department could be different than a copayment for a visit to your primary care doctor.

Out-of-pocket maximum is the most you’ll have to pay for covered services in a benefit year. After you reach this amount, your health plan will pay for all covered health benefits from an in-network provider. This limit includes deductibles, coinsurance, copayments or similar charges and any other expenditure required of an individual for a medical expense

Frequently asked questions about health insurance

Some insurance plans require you to obtain a referral from your primary care physician prior to seeing a UW Health physician or other provider. It is your responsibility to understand what is allowed in your policy and to obtain a referral if one is necessary. If you are unsure if you need a referral, you should contact your insurance company's customer service department.

To find out if UW Health is considered in-network under your insurance plan, please check your insurance company's website or call your insurance company's customer service department.

Contact your insurance company for information about benefit coverage. After you receive services, UW Health will file insurance claims on your behalf. You are responsible for payment of remaining balances after insurance.

Each insurance plan is different. Check with your insurance company if you have questions about referral, prior authorization or pre-certification requirements.