Information/FAQ

• General Billing Information
  • • 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 the 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 (ex. 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 for assistance.
  • • 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.
• 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 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 with your complete information.
• Will you bill my secondary insurance?
  • Yes, but you will need to provide us with your 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 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 - Friday, 8 am - 5 pm to answer questions about your hospital and/or clinic bill, insurance, and other concerns. They can be reached at 406-682-6842.
• 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.