Insurance and Billing Frequently Asked Questions:
Q Why were two separate charges sent to my insurance for a doctor's visit at a clinic located at UPH Kino Campus?
A Many UPH clinics utilize services at University Physicians Hospital. This allows the clinic physicians and patients to take advantage of the additional facilities and equipment of the hospital. Therefore, patients are charged a separate hospital fee for some services. Most insurers allow these charges and reimburse hospital fees for outpatient services. The majority of patients have minimal or no additional out-of-pocket expenses.


Q Why did my insurance receive two bills for the one hospital/clinic visit: one from UPH and one from University Medical Center (UMC)?
A

UMC and UPH are two separate entities. The UMC portion is for the hospital (facility) billing and the UPH portion is for physician's billing.

For questions regarding your University Medical Center (UMC) billing, please contact the UMC Customer Service Department at (520) 694-2748 or (800) 874-4708.



Q I received a bill. Why didn't you bill my insurance?
A Your insurance information is always verified by a UPH Customer Service Representative. If UPH is not contracted with your insurance carrier, we will still bill your insurance as a courtesy to you. However, the bill then remains your responsibility.

If your insurance company has denied payment, you are responsible for the full amount of the billed charges. If you feel that your charges were denied in error, contact your insurance company.


Q I just received a bill which shows that my insurance didn't pay any of my charges. Could you please re-bill my insurance?
A We cannot re-bill if the insurance has previously denied the claim. The insurance company will process the claim as a duplicate. If you feel that your insurance denied the charges in error, please call your insurance company.

As a consumer, you always have the right to appeal a decision from your insurance company. Contact your insurance company to learn about their appeal process.


Q My balance is too large to pay all at once. Do you have any other payment options?
A UPH strives to be sensitive to the financial concerns of our customers. We offer a payment plan that will allow you to make monthly payments and keep your account current. After requesting a payment plan, you will receive a written agreement in the mail. You must sign, date, and return this agreement with your first payment attached.

You may also qualify for a discount, but you must call Customer Service at (520) 874-7200 to discuss this option.


Q Why did I still receive a bill after paying my co-pay at the Emergency Room?
A In the instance of a visit to the Emergency Room, you will always receive two bills: one for the services from the physician ("professional fee") and one for the facility. Your co-pay covers the facility fee, and the bill reflects the professional fee.


Q Why didn't anyone tell me in advance that the doctor I saw at the Emergency Room was not contracted with my insurance company even though the hospital is?
A Due to a Federal statute (called "EMTALA"), the staff is unable to discuss billing or financial issues related to physician services until the patient is stabilized. The statute states that the patient should not be discouraged from receiving treatment; fear of not being able to pay a bill (because of a financial situation) may discourage a patient from accepting treatment.

Signs are posted in the Emergency Room and Urgent Care stating that patients will receive two separate bills for (1) professional fees (physician's services) and (2) facility fees (technicians, supplies, and equipment costs).

If you feel that your physician charges were denied in error, please contact your insurance company.


Q I have more than one insurance company. Was my secondary or tertiary insurance billed?
A Contact a UPH Customer Service Representative to confirm that additional insurance information is in the database. If UPH is not contracted with your primary insurance, you will need to forward the Explanation of Benefits (EOB) to UPH. UPH will then send a claim to your secondary insurance company along with a copy from your primary insurance carrier.


Q Why can't you bill my insurance for services at Integrative Medicine?
A The services rendered at Integrative Medicine are elective (not covered). With the exception of Medicare patients, all other patients will be asked for payment at the time of service. If you choose, you may then forward your receipt for payment to your insurance for possible reimbursement.


Q What do I do if I need medical services but do not have insurance or money to pay for an appointment?
A If you are uninsured or unemployed and have no financial means, let UPH know before care begins. We can provide you with information on how to apply for AHCCCS (Arizona Health Care Cost Containment System, also known as Medicaid), and other financial assistance programs.

If you do not qualify for AHCCCS, you may still be eligible to receive financial assistance. With your help, UPH will objectively determine your financial situation prior to making a financial agreement for services.

Call Customer Service at (520) 874-7200 to apply for financial assistance.


Q I am a self-pay patient and I paid in full at the time of my service. Why did I receive a bill for additional charges?
A As a self-pay patient, you made a deposit at the time of service, and should have been informed that it was a deposit only. You should have also signed a self-pay waiver stating that you, the patient, are responsible for any/all charges for services rendered. The bill you received reflects the remaining balance for the services you received.


Q How can I dispute charges on a bill?
A If you would like to dispute your bill, please document your dispute in writing and forward it to our Patient Relations Coordinator, 2701 E. Elvira Road, Bldg. 2711, Tucson, AZ 85756. You will be notified by mail when we have received your dispute. Following a thorough investigation of the dispute, the Patient Relations Coordinator will make a determination and will inform you in writing of her research results. Your account will be placed on hold during the investigation process.


Q I just received a bill for services that were rendered several months ago. Why did it take so long for me to receive this bill?
A UPH professionals certified in accurate billing procedures enter charges into the database. It normally takes them a few weeks to obtain the necessary information to enter charges. The bill is then sent to your insurance company, where, depending on the insurance, it could take them several weeks to pay their portion of the bill. Once your insurance pays, UPH bills you for the remaining balance due.


Q My adult child (over the age of 18) has a bill and I would like to discuss it.
A

Due to the Health Insurance Portability and Accountability Act (HIPAA) regulations, UPH cannot discuss information on the account unless we have prior signed consent from the patient.

 

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