Patients will only receive a bill for expenses not covered by insurance.
UMHS will no longer send “This is not a bill” statements. Instead, patients will receive detailed statements only when a balance is due, though they can request documentation of the charges sent to their insurance plan at any time.
Bills will come on a single statement.
Insurance Plan ParticipationIf we have a contract with your insurance plan, your out-of-pocket costs are limited to co-payments, co-insurance, deductibles and non-covered services. Insurance contracts change periodically, and we recommend that you speak with your insurance plan to see if they include us in their network.
If your insurance plan does not have a contract with us, we will bill them as a courtesy to you, but any amounts unpaid by your plan will be your responsibility. If we are not a participating provider, you may want to ask your insurance plan if they have participating providers in your area in order to minimize your out-of-pocket costs.
We also participate with Medicare, Medicaid, Blue Cross/Blue Shield of Michigan, TRICARE, Michigan No-Fault, and Michigan Workers Compensation. For these plans your out-of-pocket costs may be limited to co-payments, co-insurance, deductibles and non-covered services.
Visit the UofMHealth.org's Insurance web page for more information.
Referrals and AuthorizationsMany insurance plans require referrals and/or authorizations in order for services to be covered. A referral is permission from your primary care physician and your health plan to see a particular provider or to have specific procedures done. If your plan requires a referral, your primary care physician must provide the referral prior to services being rendered. If you arrive for services without a referral in place, you may be asked to sign a waiver that holds you financially responsible for the services you receive.
Authorizations are often required for procedures such as surgery or MRI. If an authorization is required, UMHS clinic staff will obtain the authorization from your health plan prior to the service. If you have questions about whether a service will be authorized, please call your health plan.