Frequently Asked Questions: Billing and Insurance
How can I best estimate my out-of-pocket cost for healthcare?
First – You must understand what kind of coverage your insurance company offers. Call your insurance company and use the following questions as a guide to better understand your coverage plan.
- What type of insurance plan do I have?
- Is Madison Memorial Hospital in my network? If the answer is yes, ask these follow up questions:
- Will my insurance plan cover inpatient and outpatient hospital costs?
- Will it cover physician costs?
- Will I need to pay a co-payment, and if so, how much?
- If I go out-of-network, what percentage of the bill will the insurance company pay?
- Will I need pre-authorization from my insurance carrier if I am to receive my planned treatment?
- How much is the out-of-pocket maximum in my insurance plan?
- If my out-of-pocket expenses reach a certain amount, will the insurance carrier ever reimburse at 100 percent?
You may also visit our Billing and Insurance Terms web page to aid you in learning about your health benefits plan.
Second – You need to estimate the cost of the future care desired. You may speak with a financial counselor at our hospital who will provide an estimate for future health services. Call 208-359-9850 for your estimate.
Third – Use the information and understanding you gained from your insurance provider along with the estimate provided by our financial counselor to project your out-of-pocket cost. Remember to account for deductibles, co-payments, co-insurance percentages, and the out-of-pocket maximum for your insurance plan.
May I still receive care at Madison Memorial Hospital if it is “out of network?”
Yes, in case of an emergency you should always go to the nearest hospital. We recommend that you call your insurance company as soon as possible to discuss payments and benefits.
You may choose to go to a medical facility “out of network;” however, you will likely experience reduced benefits. Your insurance company may require you to pay a higher portion of the bill. Speak with your insurance company representatives to better understand your health plan’s “out of network” options.
Will you bill my primary and secondary insurance carriers?
Yes, we are glad to bill your insurance providers and assist when problems arise. Sometimes we experience problems billing secondary insurance carriers because miscommunications may exist between the two. You are required to coordinate your benefits by informing your health insurance carriers if they are primary or secondary carriers. Contact your provider for help in determining the proper order for billing.
Why did my insurance provider not pay my hospital bill in full?
Insurance claims may be denied because of incorrect or missing information on the claim. Please call us immediately if you think that you need to supply Madison Memorial with the correct information, and we will update your account and re-bill your insurance provider. Billing Office: 208-359-6700
You are ultimately responsible for the cost of your care if your insurance does not pay. The following are a list of charges for which you may be responsible.
Why have I received more than one bill for my healthcare services?
You may receive more than one bill, because there are several independent healthcare providers that are involved in patient care and each receives compensation separately. Almost every time a patient receives care at a hospital he or she will receive at least two bills: one for physician services and another for facility services. A patient may also receive a bill for anesthesiology and/or radiology treatment. Many times patients will not see the anesthesiologists and/or radiologists in person and are recipients of their care. If you have wondered why you received a bill from a medical professional that you never met, this may be the reason why.
What if I do not have the money to pay a bill?
We understand that the ability to pay for care is a major concern for people with illness or injury. Madison Memorial Hospital is a non-profit community hospital that offers payment plans to help patients pay their bills. We will help you identify all of your resources and after all your options have been exhausted, you may be given a payment plan and/or receive sliding degrees of financial assistance. For more information, call the business office and select option two to speak with the correct patient representatives. Business office: 208-359-6700 (Link to our Financial Assistance webpage)
Do I need to let my insurance company know that I am in the hospital?
The Health Insurance industry has undergone numerous changes in recent years. For diverse reasons, procedures and services once covered in full are now only partially covered, covered only under certain circumstances, or in some cases not covered at all.
Because all insurance plans vary, we recommend that you check your coverage and ask questions. You can contact your insurance plan directly, or contact your employer for more information.
Your insurance coverage plan may deny payment for services even after they have been completed. Many insurance plans and health maintenance organizations (HMOs) now require pre-admission notification, approval or second opinions for certain procedures.
For your own peace of mind, we recommend that you understand the benefits of your respective plan. Not following your insurance provider’s guidelines may place larger financial responsibility upon you.
How can I pay my Madison Memorial Hospital bill?
Online – You may pay over the internet by using our secure online form.
Telephone– Make a simple call to the Billing Office to make a payment with a credit card, debit card, or electronic check transaction. Our office hours are 8:30 AM – 5:00 PM. Billing Office: 208-359-6700
Mail – You may also send your payment along with the billing statement through the mail to the Billing Office. MMH Billing PO Box 310 Rexburg, Id 83440
In Person – During business hours, you can make a payment in person to the Billing Department at 12 N. Center St. Which is located on the east side of Center St across from Taco Bell, between the Rexburg Fire Station and Progexion.
If you have any other questions we are happy to answer them. Please call the business office or come in person to speak with a customer service representative.
12 North Center St.
Rexburg, Idaho 83440
Monday – Friday 8:30 am – 5:00 pm