Billing Frequently Asked Questions

There are several ways you can pay your bill:

• Online through Inovalon^®
• In person at any of our check-in desks
• By phone, call 952-442-8054
• By mail, using the detachable portion of your billing statement.

If you need help paying your medical bills, Ridgeview provides alternative financing options. Learn more about Ridgeview’s financial assistance and payment options.

Visit our Financial Assistance & Payment Options page to learn about our Financial Assistance program.

When a charge is being considered by your insurance company, it typically will not appear on the statement until your insurance company notifies us that you have a balance due.

The time it takes to receive a bill varies depending on your insurance company. Your insurance determines whether or not you are financially responsible for a portion of services based on your deductible and coverage. You should receive an Explanation of Benefits from your insurance company informing you of claims submitted, how much is being covered by the insurance company, and how much you will owe. Once your insurance company has processed the information, you will receive a bill.

Your insurance carrier may not provide 100% coverage of your services. Refer to your insurance explanation of benefits for details and/or contact your insurance carrier for explanation of balance due.

There may be a delay in charges being submitted for billing and added to your account. It is also possible your insurance carrier may be delayed in processing your claim. Ridgeview will not send you a bill until your insurance company processes your claim.

Yes. Ridgeview offers payment withdrawals from your checking account, debit or credit card.

Ridgeview accepts a variety of health insurance plans. To verify we accept your plan, please contact your insurance company to confirm what is covered, as well as information regarding copayments, deductibles and coinsurance.

Preventive visit: The purpose of a preventive visit is to review your overall health, identify risks and plans for staying healthy. Typically, your plan covers 100% of a preventive visit when you see a doctor in your plan network.

Office visit: The purpose of an office visit is to discuss or receive treatment for a specific health concern or condition. You may have to pay for the visit as part of your deductible, copay and/or coinsurance.

If you schedule a preventive care visit and ask your doctor about a specific health concern or condition, Ridgeview may code and bill the appointment as an office visit.

A Medicare Wellness Visit is a yearly appointment with your primary care provider. This visit includes a review of your medical and family history, as well as routine measurements such as your height, weight and blood pressure. During this visit, your provider will have you fill out a Health Risk Assessment which is a questionnaire used to develop a personalized prevention plan to help you stay healthy.

You will not be charged for this visit; however, the Part B deductible may apply if your doctor performs additional tests or services during the same visit. For more information about the limitations of a free Medicare Wellness Visit, please visit medicare.gov or call 1-800-Medicare (1-800-633-4227).

As of Jan. 1, 2021, the Centers for Medicare & Medicaid Services changed the Medicare guidelines affecting the way surgeries are classified. Prior to 2021, CMS required that certain surgical services be scheduled as an inpatient surgery. With these updated guidelines, based on your medical history, your surgeon will determine whether you should be outpatient or inpatient. If your physician expects that you will need to stay in the hospital for less than two nights, you will have outpatient surgery. Your doctor and medical team will monitor your progress very closely and determine if you should stay longer.

If you only have Medicare coverage and no secondary insurance, as an outpatient surgical patient, you may have more out of pocket expense. To better understand your benefits and potential financial liability, you should contact your insurance provider to understand your coverage.

Observation status is not considered a hospitalization and does not impact your Medicare Part A benefits. Observation status is covered by Part B, and the annual deductible and copay apply. If no hospital days are used, the Part A deductible is not required. Medicare does not pay for self-administered drugs while you are in observation status. For more information, please visit medicare.gov or call 1-800-Medicare (1-800-633-4227).

Part B does not cover prescription and over-the-counter drugs you get in an outpatient setting — sometimes called “self-administered drugs.” Additionally, for safety reasons, many hospitals have policies that do not allow patients to bring prescription or other drugs from home. You will likely be required to pay out-of-pocket for these drugs and submit a claim to your drug plan for reimbursement. Call your drug plan for more information.

A facility fee/treatment room charge is how we indicate the charge for Provider-Based Billing (PBB). This means the facility functions as an extension of its respective hospital. When you receive medical care at Ridgeview Clinics, a portion of the total cost for that service is separately billed to your insurance as a hospital charge. Eligibility for “provider-based” status is determined by the Centers for Medicare & Medicaid Services. The facility fee/treatment room charge is the result of Ridgeview Clinics’ physician offices and outpatient clinics being classified as hospital outpatient departments, also called “Provider-Based Facilities.”

The Healthcare Financial Management Association (HFMA) consumer guide will help you understand the questions you should ask to avoid receiving an unexpected medical bill.