Frequently Asked Billing Questions
How will I be billed for my services at Hennepin Healthcare?
Patients who receive services at Hennepin Healthcare will be charged for services received. If the patient has insurance, the insurance will be billed first. If the patient does not have insurance, the patient will be billed directly. Whenever there is “Patient Responsibility” the patient will be billed.
What is “Patient Responsibility?”
Patient responsibility is the amount owed by the patient for services received. This amount will be billed on a statement to the guarantor. For insured patients, this is the amount owed after any insurance payments. For uninsured patients, this is the amount after any applicable discounts.
What is a “Guarantor?”
A guarantor is a person who is responsible to pay the patient’s bill. In many cases, the guarantor is the patient; however, it could be a parent, guardian or some other identified person.
When will the patient/guarantor receive a statement?
Statements are sent whenever there is an amount owed by the patient. This is also called “patient responsibility.”
When are statements sent?
Statements are sent once the balance of the account is considered patient responsibility.
Why are statements sometimes sent months after services were received?
Statements are generally sent within 30 days once final payment is received from a patient’s insurance company. Any delays in receiving the insurance payment would cause a delay in the statement since patients are not billed until their insurance(s) have paid the account.
What should a patient do if he/she questions the charges and/or the services listed on the statement?
Contact Billing Customer Service at 1-800-495-4915 to answer any questions.
What should I do if I am on a payment plan and incur new charges?
If you have received services after your payment plan was set up, you will need to call customer service 1-800-495-4915 to have your account balance added. This could change your payment plan amount.
How does the insurance company determine what it pays?
Insurance payments are based on the specific insurance plan of the patient. Co-pays, deductibles and co-insurance all impact the amount the insurance company will pay on a claim.
What is the difference between a claim and a statement?
A claim is the bill sent to the insurance company; a statement is the bill sent to the patient/guarantor.
What is a co-pay?
A co-pay is a small dollar amount the insurance company determines a patient must pay to receive services.
What is a deductible?
The amount a patient must pay before the insurance company begins paying. This amount is determined by the patient’s insurance plan.
What is co-insurance?
The amount a patient’s insurance requires the patient to pay. This is often a percentage. Example: The insurance pays 80% of a claim and the patient pays 20%,
Who should the patient contact if there are questions about how much the insurance company has paid?
Patients should contact the insurance company about any questions about the insurance company’s payments.
What is a network?
Some insurance plans require patients to be seen within a network. A network is determined by the insurance company. It is a group of providers (hospitals, clinics, doctors, etc) where the insurance company wants patients to be seen. Seeing a provider not in the network is called “out of network.”
What does it mean if a patient is seen “out of network?”
If a patient is seen “out of network” the insurance company will pay less or not at all. A patient should contact the insurance company regarding questions about network coverage.
What forms of payment are accepted?
Statements can be paid with cash, check or credit card, money order, or PayPal.
Where can I pay the statement?
Statements can be paid via mail, online, in-person or by calling customer service.
By Mail: Payments can be made using the envelope included with the statement.
Online: Payments can be made at hcmc.simpleepay.com.
In-person: Payments can be made at the Clinic & Specialty Center Building (1st floor-Financial Counseling office) and the Shapiro Building (1st floor-S1.143).
Customer service: 1-800-495-4915.
Does the entire statement amount need to be paid at one time?
No. Although payment in full is preferred, a payment plan can be requested by calling customer service at 1-800-495-4915. Payment plans can also be set up online at hcmc.simpleepay.com.
What happens if the statement is not paid?
Unpaid balances will be sent to a collection agency.
What options are available for patients without insurance?
Patients without insurance are called uninsured or self-pay patients. Financial Counselors are available to help uninsured/self-pay patients apply for eligible programs.
How do I reach a Financial Counselor?
Counselors can be reached via phone at 612-873-2767. You may also meet with a Financial Counselor in person at the following locations list Purple 1st floor and Green 9th floor.
Do uninsured/self-pay patients need to make a payment prior to receiving services?
Uninsured/Self-pay patients are asked to make a small down payment at the time of service. The remainder of the bill will be billed on a statement.
Are there any discounts available for uninsured/self-pay patients?
The Minnesota Attorney General requires Minnesota hospitals to offer a self-pay discount. The amount of the discount varies. The amount owed on the statement will include the discount.
Is it possible to know prior to being seen how much services will cost?
Patients are able to receive a price estimate prior to receiving services. The estimate is an “estimate.” Actual services may be more or less expensive depending on the actual services provided. Access the Price Estimate Form.
Hospital Based Clinics
What does it mean to be a “hospital based clinic?”
A hospital-based clinic is a clinic that is owned and operated by a hospital. It is common for large, integrated healthcare systems like HCMC, where the hospital owns or leases space and employs support personnel involved in patient care, to operate hospital-based clinics.
Which Hennepin Healthcare Clinics are hospital-based clinics?
All HCMC clinics except the Golden Valley Clinic, Richfield Clinic, St. Anthony Village Clinic, Parkside Occupational and Contact Dermatitis Clinic and the BeWell Clinic are hospital-based clinics.
How does this affect billing?
When you receive care you may receive two separate charges on the statement. The facility fee(s), including the cost of nursing staff, supplies, equipment, and building expenses, and the provider related fees.
Will patients pay more for services provided at a hospital-based clinic?
Each patient’s insurance plan is unique to that patient and contracted provider. A patient’s insurance plan may cover the services differently for a hospital-based clinic, which could impact what is owed. Some insurance companies may cover both the facility fee and provider fee and some may not. If not, all or a portion of the facility portion may be patient responsibility. Patients should check with their insurance company to review the patient’s insurance benefits and determine what out-of-pocket expenses, such as deductibles or coinsurance payments may be required.
What should I ask my insurance provider?
Making informed healthcare purchasing decisions is important. Patients should ask the insurance company if they cover facility charges in a "Hospital-Based Outpatient" or "Provider-Based" location. If they do, ask how much of the charge is covered or will be applied to the deductible. Also verify the co-pay responsibilities for the type of visit.
Find more information about Hospital-Based Clinics.
Additional Billing Questions
Who should I contact if my insurance denies my claim?
Each patient’s insurance is based on their individual policy. It is best to contact your insurance company to find out why your insurance denied. If you have any questions after talking with your insurance, please contact customer service at 1-800-495-4915.
Who should I contact if I have questions regarding my charges?
Call customer service at 1-800-495-4915.
Who should I contact if I have questions about my account balance?
Call customer service at 1-800-495-4915.