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Billing and Financial

Frequently Asked Questions

The following FAQs may help you answer questions about your Partners HealthCare bill or the billing process.

 

What is the Cooley Dickinson Hospital Patient Accounts contact information?

Phone: 617-726-3884

 

What are the hours of operation?

Telephone: 8 AM– 4:30 PM EST

Why did I receive a bill from Cooley Dickinson Hospital?

There could be a variety of reasons why you received a bill from Cooley Dickinson Hospital, Including:

  • You don’t have health insurance.
  • The service you received is not covered by your insurance.
  • You have a co-payment, co-insurance, or deductible that you did not pay at your visit.
  • You did not get a required referral from your doctor.
  • You received care outside your provider network.
  • You used up your insurance benefits. (Some health insurance companies limit coverage.)

 

Why am I getting more than one bill for the same service?

You may receive separate bills from the hospital and the doctor for services.

The hospital portion is for items such as medical equipment, technology, medical supplies, lab tests, radiology, and hospital rooms.

The professional portion is for the time the caregiver spends during the visit treating you, reading test results, and coordinating your care.

If you are not sure how your health insurance plan will process claims, call 617-726-3884 to ask what you’ll pay out of pocket.

 

Why did I receive a bill from a physician whom I did not see?

Some visits also have charges for ancillary departments (e.g., Radiology, Pathology, Anesthesia, etc.); please check to see if your bill includes an ancillary charge.

 

If you still believe that you received a bill in error, please call 617-726-3884.

 

When will I receive a bill?

Patients are billed as soon as possible after their provider’s appointment or hospital stay.

  • Typically, bills are not sent until all insurance claims have been processed.
  • Patients without insurance receive bills directly.
  • Bill cycles are every 25 days.
  • Once a bill is received, patients are given 21 days to pay their bills in full; the due date will be noted on your bill.

 

How can I pay my bill?

There are a few payment options.

  • Pay your Cooley Dickinson Hospital bill online at www.patientgateway.org
  • Call 617-726-3884 to pay your bill by phone
  • Send a check or money order made payable to Cooley Dickinson Health Care to the following mailing address:

 

Cooley Dickinson Hospital

P.O. Box 412026

Boston, MA 02241-2026

 

Can I pay my bill with a credit card?

Yes, Cooley Dickinson Health Care accepts Visa, MasterCard, Discover, American Express, and electronic checks.

Visit www.patientgateway.org  to pay your bill securely online.

Please call 617-726-3884 to process your credit card via the telephone.

 

What if I cannot pay my entire bill?

Visit our Financial Assistance Page to learn more about discounts available to our patients, as well as the ability to create a payment plan.

You can also visit a patient financial counselor in person.

 

Whom do I contact if I do not have insurance?

Cooley Dickinson Hospital offers several programs for patients who are underinsured or who do not have insurance coverage.

 

If you live in Massachusetts, you may be able to get health insurance or help paying your health care bills through a state program like MassHealth, Health Connector, and Health Safety Net.

You can also visit a patient financial counselor at the hospital in person or learn more about financial assistance options through Hampshire HealthConnect.

You can also contact Hampshire Health Connect at 413-582-2848 for questions about what to do if you do not have insurance.

 

Why didn’t my insurance pay for my services?

Your insurance carrier will forward an explanation of benefits (EOB) for your review; the form explains the payment or denial reason for the services rendered.

 

What if my insurance information has changed?

Please call 617-726-3884 and they will be happy to update your insurance information for you.

 

What if my address has changed?

Please call 617-726-3884 and they will be happy to update your address information for you.

 

If I updated my insurance information, do I have to call my insurance company to pay my bill?

If you updated your insurance information with Patient Accounts, we will re-submit your bill to your updated insurance company to request payment.

 

Do I have to submit my bill to my secondary insurance?

If we have all of your insurance information, we will bill your secondary insurance on your behalf.

 

What is an Explanation of Benefits (EOB)?

An EOB is the notice you receive from your insurance company after getting medical services from a doctor or hospital. It tells you what was billed, the payment amount approved by your insurance, the amount paid, and what you have to pay.

Find explanations of this and other billing terminology on our Patient Billing Terms page.

 

What is a co-payment?

Copayments are set amounts you pay when you go to a health care provider. Providers usually collect copayments at the visit. Copayment amounts are listed on your health insurance card. For example, an Emergency Department copay $50.

 

Find explanations of this and other billing terminology on our Patient Billing Terms page.

 

What is a deductible?

Deductibles are the yearly expenses you pay before your health insurance pays anything. For example, each year you may pay the first $1,000 of your health care bills before your health insurance pays anything. Your out-of-pocket cost is based on the total amount that your insurance has allowed for the visit, NOT on the hospital charges.

Find explanations of this and other billing terminology on our Patient Billing Terms page.

 

What is coinsurance?

Coinsurance is a percentage of the health care bill that you pay. For example, you pay 20% and your insurance company pays 80%. Your out-of-pocket cost is based on the total amount that your insurance has allowed for the visit, NOT on the hospital charges.

 

Find explanations of this and other billing terminology on our Patient Billing Terms page.

 

What is a referral?

Approval needed for care beyond that provided by your primary care doctor or hospital. For example, managed care plans usually require referrals from your primary
care doctor to see specialists or for special procedures. Administrative referrals require minimal clinical information (i.e., diagnosis) and clinician involvement for the approval process.

Find explanations of this and other billing terminology on our Patient Billing Terms page.

More Information

General Information
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Urgent Care Billing at Partners HealthCare

Urgent Care services are available at multiple Partners HealthCare locations.

The billing information below does not apply to Urgent Care services provided at centers named “Partners Urgent Care” located in Boston and surrounding communities.

How Urgent Care Billing May Affect Me

Since the locations listed below are not considered by health insurance plans to be Urgent Care Centers, your co-payment benefits for urgent care services typically will not apply. Instead, your visit to these locations will likely be billed either as a physician office visit or a hospital outpatient visit.

Physician Office Locations

  • Urgent Care services provided at the following Partners HealthCare locations are typically billed to your health insurance plan as a physician or nurse practitioner office visit:
  • Cooley Dickinson Urgent Care, Northampton, MA
  • Harbor Medical Associates Urgent Care, South Weymouth, MA
  • North Shore Urgent Care, Danvers, MA
  • Pentucket Medical ExpressCare Andover, MA • Lawrence, MA

Hospital Outpatient Locations

  • Urgent Care services provided at the following Partners HealthCare locations are typically billed to your health insurance plan as a hospital outpatient visit:
  • Brigham and Women’s Urgent Care Center, Foxborough, MA
  • Newton-Wellesley Urgent Care Center—Waltham, Waltham, MA
  • Massachusetts General Hospital Chelsea HealthCare Center Urgent Care, Chelsea, MA
  • Massachusetts General Hospital Medical Walk-In Unit, Boston, MA

Understanding Whether My Urgent Care Visit Takes Place at a Physician Office or a Hospital Outpatient Center

You can find information about whether your visit is a physician office or hospital outpatient visit in notices in our waiting rooms, on the websites of our hospitals and physician groups, and in this guide.

Payment Responsibility for Urgent Care Services at the Locations Listed in This Guide

For physician office locations:

  • Urgent Care services are typically billed as a physician or nurse practitioner visit, and your out-of-pocket costs are usually limited to the co-payment required by your health insurance plan.
  • We will request your co-payment when you check in for the visit.

For hospital outpatient locations:

  • Your out-of-pocket costs for the physician or nurse practitioner visit are usually limited to the co-payment required by your health insurance plan. We will request your co-payment when you check in for the visit.
  • You will also be billed for what is commonly known as a “facility fee” for use of the hospital space, equipment, and support staff.
  • Your health insurance plan may apply these hospital fees to your annual deductible, and after you have paid your deductible in full, you may be billed for a co-insurance payment.
  • We will send you a bill if there is any unpaid balance after we receive payment for your visit from your health insurance plan.

Referrals and Prior Authorizations

For both physician office visits and hospital outpatient visits, your health insurance plan may require you to get a referral or authorization. In addition, Partners HealthCare providers may be considered “In Network” or “Out of Network” depending on the specifics of your health insurance plan, which could affect the amount you pay.

Billing for Procedures Performed During the Visit

No matter the location, if a procedure is performed during the visit, you may have further out-of-pocket costs for additional physicians’ services and for use of the hospital facilities and staff, even if the procedure was performed in the same exam room as the visit with the physician. Your health insurance plan may apply these additional physician and hospital charges to your annual deductible, and after you have paid your deductible in full, you may be responsible for an additional co-insurance payment.

Laboratory and Imaging Services

If your physician ordered laboratory tests or imaging services (such as X-ray, CT or MRI), you will be billed for these tests by the hospital, clinical laboratory, or imaging center, and you may also be billed for the services of the physicians (usually pathologists and radiologists) who interpreted the test results.

Special Notice for Medicare Patients

If you are a Medicare beneficiary and your visit takes place in a hospital outpatient location, you will be responsible for a Medicare Part B out-of-pocket co-insurance payment of approximately $25 for the hospital facility charge. Procedure charges or other testing could increase your out-of-pocket expense.

Understanding How Much My Visit Will Cost

It is your right to receive an estimate of the cost of your visit in advance of the visit. Please contact Partners Patient Billing Solutions (see below) at least two business days prior to your visit to get an estimate. Please have as many details as possible about the upcoming visit, including the provider name, location, and details of the planned service or procedure.

Please contact the Member Services department of your health insurance plan to verify your coverage and financial responsibility for Urgent Care services provided at any of the locations listed on this page. This phone number is usually located on your insurance card.

If Your Insurance Company Does Not Answer all of Your Questions, Please Contact Partners Patient Billing Solutions:

Mailing Address
Patient Billing Solutions
Partners HealthCare
399 Revolution Drive, Suite 410
Somerville, MA 02145–1462

Phone
(617) 726-3884

Monday–Friday, 8:00 AM to 4:30 PM

Email
patientbilling@partners.org

www.partners.org/patientbilling

 


Preventive Health Exam Billing at Partners HealthCare

What is a Preventive Health Exam and is it Covered by My Insurance?

A preventive health exam is an Annual Physical during which your primary care provider will:

  • Ask you questions about your health
  • Do a physical examination
  • Give you advice about how to prevent health problems
  • Take care of minor health problems or a chronic illness that has not changed

Commercial Health Plans

Under the Affordable Care Act, commercial health plans are required to cover an annual Preventive Health Exam at no cost to the patient (no co-payment, co-insurance or deductible).

Medicare Advantage

Many Medicare Advantage plans will also pay the full cost of Preventive Health Exams as defined in this guide.

Medicare Part B

Annual Wellness Visit

Medicare Part B covers a different version of an annual visit, called a “Medicare Annual Wellness Visit.”

During your Medicare Annual Wellness Visit your provider will:

  • Ask you questions about your health, and family and social history
  • Provide advice about how to prevent health problems, including a plan for screening in the future
  • Screen you for depression and other mental health or safety concerns

A Medicare Annual Wellness Visit does not include a physical exam. If your provider does perform a physical exam during your visit to assess your health or treat any medical problems, you may be responsible for a co-insurance or a Medicare Part B deductible payment.

“Welcome to Medicare” Visit

During your first 12 months of enrollment in Medicare Part B, a “Welcome to Medicare” visit is covered, which includes a physical examination.

When Would any of These Annual Health Visits Turn into a Sick or Chronic Disease Visit?

Sometimes, your annual Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit can turn into a “Sick Visit”.

During your visit, your provider may need to treat a new medical issue or a chronic problem that has changed. If that occurs, this part of the visit is called a Sick Visit and may result in additional services being billed to your insurance.

Most insurance companies will pay for Sick Visit evaluations, tests, and treatments, but your insurance plan may require you to pay a co-payment, deductible, and/or co-insurance payment for the Sick Visit, even when it is done during the same appointment as your Preventive Health Exam, Medicare Annual Wellness Visit, or Welcome to Medicare Visit.

Are Lab Tests for Disease Screening and Immunizations Covered During My Annual Health Visits?

Medicare and many commercial health insurance plans cover certain screening tests (such as cancer and cardiovascular disease screening) and immunizations. Specific coverage depends on your age and health insurance plan. Some tests and immunizations may not be covered at 100% and some may not be covered at all. In those cases you may be responsible for a co-insurance or deductible payment.

When Will I Have to Pay?

We will request your co-payment when you check in for a visit. We will send you a bill if there is any unpaid balance after we receive payment for your visit from your insurance company.

It is important that you understand your health insurance benefits, and we encourage you to contact your health insurance plan if you have any questions about what is included in your Preventive Health Exam, Medicare Annual Wellness Visit or Welcome to Medicare Visit, or about charges for Sick Visits, lab tests, immunizations and other services that are performed during your Preventive Health Exam, Medicare Annual Wellness or Welcome to Medicare Visit.

If Your Insurance Company Does Not Answer all of Your Questions, Please Contact Partners Patient Billing Solutions:

Mailing Address

Patient Billing Solutions
Partners HealthCare
399 Revolution Drive, Suite 410
Somerville, MA 02145–1462

Phone
617-726-3884

Monday–Friday, 8:00 AM to 4:30 PM

Email
patientbilling@partners.org

www.partners.org/patientbilling

 

 

 

Updated April 2019