Billing & Insurance Plain Language Summary

Billing Overview

For services rendered at Alexandria Clinic, Alomere Health, and Heartland Orthopedic Specialists, patients receive one convenient monthly statement. Fees for services rendered by anesthesiologists, oncologists, and other physicians will be sent directly from their billing offices.

Full payment is due and payable upon receipt of the first statement. Payment plans may be approved by an Account Services Representative for patients unable to pay in one installment. Self-pay balances remaining due after 30 days are subject to a finance charge of 6% per annum.

Alomere Health is not required to accept patient-initiated payment arrangements and may refer accounts to a collection agency if patient is unwilling to make acceptable payment arrangements or has defaulted on an established payment plan.

Insurance

Please present your health insurance information and identification cards upon admission. Co-pays are payable on the day of service. Pre-payment is required for services that are deemed to be not medically necessary by insurance plans and for uninsured patients.

Please check with your insurance carrier by calling the number on the back of your card to verify if services provided would be processed "in network."

Uninsured Patients

Uninsured patients will receive an uninsured discount for medically necessary services. Payments are due upon receipt unless other arrangements have been made. Those in need of care for which they are unable to pay may partner with our Account Services Representatives; our team of professionals are ready and willing to help you complete applications for assistance. Please let us know of your concerns as soon as possible so that we can explain the options available to help with your specific needs.

Applying for Financial Assistance

To apply for financial assistance, patients must submit a signed, completed application with supporting documents by mail to: Account Services Representatives, Alomere Health, 111 17th Avenue East, Alexandria, MN 56308. Applications may also be presented in person at one of our conveniently located offices at Alexandria Clinic, Alomere Health, or Heartland Orthopedic Specialists.

In addition to assisting our patients with financial assistance applications, some of the services provided by our Account Services Representatives include:

• Estimates of costs prior to service
• Pre-service payment options
• Financial counseling
• Questions or concerns regarding the billing
• Assistance in making a payment or setting up a payment plan. For patient convenience, we accept Mastercard, Visa, Discover, and American Express.

Services Eligible for Financial Assistance

Services eligible for financial assistance include services deemed medically necessary by Douglas County. Patients who are uninsured or underinsured and have a household income between 100% and 244% of the Federal Poverty Guidelines (FPG) or below may qualify for our financial assistance program. Uninsured patients will receive an uninsured discount on medically necessary services.

Collection Accounts

If your account is past due and has been sent to a collection agency:

• In certain instances, we will not be able to honor your requests for appointments with Alexandria Clinic or Heartland Orthopedic Specialists until the past due balances have been paid in full or resolved through our Community Uncompensated Care program.
• The collection agency may request authorization for legal handling.
• A claim maybe submitted to the MN Revenue Recapture program where your future state income and property tax refunds, lottery winnings and other sources may be used to offset your debt as allowed under the Revenue Recapture Act MN Statute 270A. The MN Department of Revenue will apply a $15 fee each time a refund is sent to us and will continue each year until your balance is paid in full.

On our Web site, you can:

• Pay our bill online
• Use MyChart
• Access Release of Information forms
• Access applications for our financial assistance program