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Will my Insurance pay for may care at Marshall Medical Center? The
following questions may help guide you in better understanding your
insurance and how it works: 1.
Is this
care a covered service under my insurance policy? Read your policy booklet
or call the customer service number on your insurance card. It is
important that when you receive a service, the facility, the physician,
and the service are all part of your insurance benefits. 2.
Have I met
my deductible? Call the customer service number on your insurance card.
They can help you estimate what your financial responsibility will be for
your medical services. 3.
Is
pre-authorization required from my insurance company? Your physician may
need to get pre-authorization for the care you receive at Marshall Medical
Center. Check your policy booklet or call the customer service number on
your insurance card. If you think pre-authorization is needed, find out if
your doctor has obtained authorization before you come to Marshall Medical
Center. If pre-authorization is needed and your doctor does not get it,
you may have to pay for the care. 4.
Is this an
emergency? If you come to our emergency room, you are entitled, by law, to
receive an emergency medical screening exam, regardless of your insurance
or your ability to pay. Your insurance must pay for the exam, as long as a
prudent person would have believed an emergency existed. 5.
Is Marshall
Medical Center a covered provider under my insurance? Check your policy
booklet or list of providers given to you by your insurance company OR
call the customer service number on your insurance card to see if care is
covered at Marshall Medical Center. See below for more information about
the relationship between Marshall Medical Center and your insurance.
Will Marshall Medical Center bill my insurance? Yes.
You may be asked to give us your insurance card or other information about
your insurance. Even if Marshall Medical Center bills your insurance, you
remain responsible for payment for all care you receive. This may include
care denied or not covered by your insurance, as well as your deductible
and co-payment amounts. Is Marshall Medical Center contracted with my insurance? We
cannot answer this question because we do not have information about the
plan you have chosen with your insurance company. Insurance companies sell many
types of plans. Marshall Medical Center may be contracted with your
insurance company, but not for all of the plans they offer. For example,
services at Marshall Medical Center may be covered for someone with a PPO
policy from Acme Insurance, but not for someone with an HMO policy from
Acme Insurance. Insurance plans may say that some services must be
provided at places other than Marshall Medical Center, even if a contract
with your insurance company is in place with Marshall Medical Center.
Ultimately, understanding your insurance is your responsibility. Please
call the customer service number on your card to avoid any financial
penalties for not following your insurance plan guidelines. In
addition, certain insurance companies may use other networks of other
insurance companies, and not tell Marshall Medical Center. Therefore,
services at Marshall Medical Center may be covered through one of these
networks, even though your insurance does not have a direct contract. Can I still get my care at Marshall Medical Center, even if my insurance may not cover the services? We welcome the opportunity to provide you with excellent healthcare, regardless of your insurance. You should be aware that you may have to pay for the services you receive. However, you can choose to get your health care where you feel comfortable. The
care you receive at Marshall Medical Center includes Facility Services
provided by Marshall Medical Center. Your care may require Professional
Services provided by physicians. These physicians are separate from
Marshall Medical Center and will bill you directly. Verify
that both Marshall Medical Center and the doctor are contracted with your
insurance. It is possible that your insurance company is contracted with
Marshall Medical Center, but not the physician providing your care…and
vice versa. Some
of the physician services provided within Marshall Medical Center include:
Some
of the physician groups which provide care at Marshall Medical Center are
the Marshall Center for Primary Care, Emergency Physicians Medical Group,
El Dorado Anesthesia Group, Placerville Radiology Medical Group, and El
Dorado Pathology Medical Group. |
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