Billing and Financial Services
Hours of Operation:
8:00 a.m.-5:00 p.m.
Download Medical Records Release
2019 Charge Master
Medical billing is an extremely confusing and in-depth process. Therefore,
for your convenience, we have included this explanation to some basic
billing issues and Frequently Asked Questions.
- Each time you receive services from the hospital and/or the clinic, an
admission is created in your name. We will process your account based
upon the information you provide to us. Please make sure your demographic
information is current.
- If your insurance information is provided at time of service, we will bill
your insurance company. In order to expedite the proper billing of your
insurance, please make sure you provide us with your current insurance
card when services are rendered. Also, it is important that you understand
the benefit coverage offered by your insurance plan(s).
- When MVMC receives payment from your insurance company, we will bill you
for any remaining portion (e.g. co-pay, co-insurance, deductible, non-covered
services, etc.). Once a month, you will receive a statement showing that
your account is “pending insurance” or in self-pay. Please
verify that all information is accurate. If not, please contact patient
account representative in the business office.
- You should receive a Medicare Summary Notice ("MSN") or an Explanation
of Benefits ("EOB") from your insurance company, which explains
what your insurance paid and what remaining balance is your responsibility.
If you do not receive an MSN or EOB, or if you have questions regarding
your health benefits, please contact your insurance company directly by
calling the number listed on your insurance card.
- If you do not have insurance, there are other resources available to assist
you with your medical costs. Please let a patient account representative
know your situation and we will be glad to help you explore other avenues
- Once an account becomes patient's responsibility, you will receive
a statement showing the balance due for each date of service. Monthly
statements will be sent in order to keep you informed of the status of
your account(s). We want you to know that we are here to make this process
as seamless as possible for you. Please keep in mind that you are ultimately
responsible for your accounts. We are only able to work with the information
that you provide. For that reason it is extremely important that you provide
us with up-to-date contact and payer information.
- Please let us know if you have questions regarding your account(s) or if
you would like to discuss payment options. Our Patient Account Representatives
can be reached at 406-682-6842.
Frequently Asked Questions
Can you bill worker's compensation for my claim?
Yes. In order for us to file a claim with workers’ compensation,
we must have some information. First, you need to let us know that it
is a workers compensation claim. Second, we must have the name, address,
and phone number of the insurance carrier. Last, we need the claim number
and the date of injury.
Can you provide me an estimate for a certain procedure?
Yes, we can provide an estimate. However, we will need the following information from you:
- A CPT (Current Procedural Terminology) code, which can be obtained from
your physician and the name of the procedure. This often takes time to
research, so please make sure that we have correct contact information on file.
Will you bill my primary insurance?
Yes, but you will need to provide us complete information.
Will you bill my secondary insurance?
Yes, but you will need to provide us complete information.
Why is this billed as an outpatient service when I spent the night in the hospital?
For an account to be billed as an inpatient service, there must be a physician
order. The physician who ordered your services determined that your condition
did not meet the requirement for an inpatient admission. The physician's
written order dictates whether we bill as an inpatient or outpatient.
Why did my insurance deny the claim?
The most common reasons for denial of a claim:
- The service you received was from a physician outside your plan's network.
- The service you received was not covered under your plan.
- You were not covered by your plan at the time of service.
- You did not provide the correct insurance information at the time of service.
What is this balance for?
Please contact the business office and we can answer this question. We
will need your medical record or admission number and the charge in question.
We will also be happy to send you an itemized summary of your account.
Who can I talk to if I have questions about my bill?
Patient account representatives are available in our business office Monday
through Friday, 8:00 am - 5:00 pm to answer questions about your hospital
and/or clinic bill, insurance, and other concerns. They can be reached
Is my insurance accepted at your facility?
MVMC will submit a claim to any insurance that you provide. However, it
is possible that we are not contracted your insurance. It is always a
good idea to check with both MVMC and your insurance carrier to verify
that we are in network with your plan.
Why am I getting a bill when it looks like Medicare paid the balance?
Madison Valley Medical Center is classified as a Critical Access Hospital
and Madison Valley Clinic is classified as a Rural Health Clinic through
Medicare. This means that we are on what is called a “cost-based
reimbursement” system. Cost-based reimbursement simply means that
Medicare reimburses us what they decide that we should be paid in order
to keep the doors open. Medicare makes this determination based on an
annual report that we are required to submit. The payment from Medicare
on your bill does not affect your coinsurance or deductible amount in
any way. In other words, you still owe the coinsurance or deductible for
your bill regardless of what Medicare has paid to MVMC.