Lifespan Urgent Care Billing and Collection Policy

Lifespan Urgent Care is committed to providing you comprehensive, compassionate, and convenient healthcare at a price you can afford. Lifespan Urgent Care recognizes the cost of necessary health care services can impose a financial burden on patients who are uninsured or underinsured and has acted to lessen that burden for patients. Lifespan Urgent Care also recognizes the billing and collection process is complex and has implemented procedures to make the process more understandable for patients; and to inform patients about discounts and financial assistance options.

Patients without Insurance

We accept patients without insurance. Payment is due and expected at time of service. Best efforts will be made by the Lifespan Urgent Care Center to estimate the total charges for your visit. Payment for a basic visit is required up front. Lifespan Urgent Care offers an affordable prompt pay discount tiered-level rate which is based on medical necessity to cover self-pay services. The appropriate tier price is subject to the clinical assessment and the medical and professional discretion of the provider who is providing these services. As services become more complex, the tier begins to increase, and services become costlier.

Patients with Participating Insurances

Lifespan Urgent Care participates with a variety of insurance plans. We encourage all of our patients to contact their insurance company prior to treatment to make sure that the visit will be covered at our facility. It is the patient’s responsibility to:

Understand your insurance plan benefits and requirements, including co-payment/co-insurance and/or deductibles.
Understand if your insurance requires a referral or an authorization for you to be seen and obtain it PRIOR to your visit.
Make sure to provide all your insurance information when you visit. We will ask to make copies of your insurance cards at the time of your visit. This will ensure we accurately bill your insurance.
Bring an accepted form of payment and be prepared to pay any unmet deductible and your co-payment before each visit.
Make full payment for medical care not covered under insurance. Lifespan Urgent Care requires payment at the time of service.
Contact your insurance provider at the number listed on your insurance card if you have questions about your out of pocket responsibilities.
Make sure we have your correct address information on file. Pease advise us anytime there is any change to your address, telephone or other contact information.

Self-Pay Tiered-Level Rate

We offer a prompt pay discount to patients who do not have health insurance and those patients who do NOT want us to bill their insurance company.

Under the prompt pay discount program, Lifespan Urgent Care offers a tiered-level rate approach which is based on medical necessity to cover self-pay services. The appropriate tier price is subject to the clinical assessment and the medical and professional discretion of the provider who is providing these services. As services become more complex, the tier begins to rise, and services become costlier.

Direct Billing to the Insurance Providers

On your behalf, Lifespan Urgent Care will verify your coverage during your visit. After verification we will bill your insurance company on your behalf for the services we provide. Once we have heard back from your insurance providers, we will send you a detailed statement. This statement will explain the payments that we received and the remaining balance, if any.

You should also receive an Explanation of Benefits (EOB) from your insurance company. It will list the services provided at Lifespan Urgent Care, the amount that was billed, all payments made by your insurance provider and what is your responsibility to pay.

Copayment and Deductibles

We want to help patients better understand why they are being charged a certain amount, and why these amounts may differ from those charged to other family member or friends. It is important to understand that a patient’s out of pocket amount is determined by the insurance plan chosen by the policy holder and/or their employer. Some employers offer employees a variety of plans, from several different insurance companies, from which to choose. The cost of the plan is often directly related to the deductible/copayment amounts, the higher the monthly premium, the lower the deductible/co-payments, and vice versa. Rest assured, we charge from a standard fee schedule, and any differences in charges from person to person stem from differences in insurance coverage and/or the status of an individual’s deductible at the time of visit. Copayments and deductibles are a contractual responsibility between you and your insurance company and are non-negotiable. It is our policy to collect all co-payments and/or any unmet deductible during the registration process at every visit. If you still have questions regarding your charges, you are encouraged to call our billing office at 1-800-884-6966.

Authorizations/Referrals

It is the patient’s responsibility to contact your primary care provider for any required referrals and/or comply with your insurance carrier’s policy regarding authorizations for urgent care services. The patient is responsible for any services denied for no referral or authorization.

Non-Participating Insurances or Out-of-Network

If you have insurance that Lifespan Urgent Care does not participate in, you will be responsible for full payment of all services at the time they are rendered. As a courtesy, our billing office will file a claim with your insurance. If any portion of your visit was covered, you will be sent a refund.

Non-Covered Services

Please be aware that some, and perhaps all, of the items or services you receive may not be a covered benefit under your insurance plan. You will be responsible for payment, in-full and at the time of service, for any non-covered items and/or services. Medicare patients may be required to complete an executed Advanced Beneficiary Notice (ABN).

Secondary Insurance

If you have insurance coverage under more than one plan, we will courtesy file with your secondary insurance. Depending on the scope of the coverage, the secondary insurance may pick up costs that the primary coverage didn’t cover. To do this, we will need to know which plan is primary and which plan is secondary. Medicare patients with dual coverage must answer questions so that we can complete a Medicare Secondary Payer Questionnaire.

Motor Vehicle Accidents and Third-Party Payers

Lifespan Urgent Care does NOT file claims to auto carriers or accept liens; you will be responsible for full payment of all services at the time they are rendered.

Worker’s Compensation or On-the-Job Injuries

Lifespan Urgent Care does not accept Workers Compensation insurance plans. You will be responsible for full payment of all services at the time they are rendered.

Payment Arrangements

Typically, Lifespan Urgent Care does not make payment arrangements. In the event you have a balance remaining after insurance has paid or if they deny the claim, the balance is due in full; however, if you are unable to make the full payment, you may call us to make arrangements to bring your account current.

Past Due Accounts and Collections Accounts

Payment is due upon receipt of your statement. If your account is past due or has been turned over to a collection agency and you want to be seen, you are expected to pay the past due balance in full, as well as any current charges for which you are responsible. If payment is made by check and the check is returned by your bank for any reason, a $25.00 returned check fee will be added to your account.

Durable Medical Equipment (DME)

The DME equipment available at Lifespan Urgent Care Center prescribed by your provider will be billed by Lifespan Home Medical. DME equipment is not included in the Urgent Care bill.

Treatment of a Minor

If the patient is a minor (under18 years of age), the parent or legal guardian must complete all registration forms. The parent or legal guardian of a minor is financially responsible for payment at the time of service, as well as obtaining any required referrals and providing insurance and picture ID cards. Minors must be accompanied by a parent/legal guardian or by a designated adult who has been given written permission to make medical decisions, on behalf of the parent/guardian, for the minor child.

Please Note: Our office can only discuss billing information (no medical information) on an account for a patient 18 years of age and older, regardless if the parent is financially responsible.

Financial Responsibility

The patient and/or guarantor are ultimately responsible for all charges associated with your visit regardless of insurance coverage. All balances from previous visit(s) are due and payable prior to any new visits. If your health insurance policy contains a deductible, we will require a preauthorized hold on a major credit card for future balances. We will verify your insurance benefits to the best of our ability, however, there may be additional balances due after your health insurance processes your claim according to your benefits.

Financial Assistance Policy and Application

Lifespan Urgent Care understands that it can be difficult for some patients to afford paying their Medical bills. Please contact our billing office at 1-800-884-6966 for information regarding eligibility or the programs that may be available to you. Lifespan Urgent Care follows Lifespan’s Financial Assistance Program for Uninsured Patients Policy, which includes eligibility criteria, the basis for calculating discounts and the method for applying the policy.

To determine if you may be eligible for available financial assistance programs, you must provide a completed Financial Assistance Application. The Lifespan policy and the Financial Assistance Application can be found at www.lifespan.org. Upon receipt, we will process your application and notify you of our determination.

Credit Card Hold

Lifespan Urgent Care requires that patients provide a credit card to hold on file. All credit card data is encrypted via a tokenization system provided by our credit care processor, Trust Commerce. No credit card information is stored on Lifespan’s network. If you sign the credit card acknowledgement, Lifespan Urgent Care will not charge your card without first notifying you with a statement after your claim has been submitted to, and paid by, your insurance provider. Upon receipt of the statement you will have 2 weeks to contact Lifespan Urgent Care to pay via your preferred method (cash, check, credit card). If you do not contact Lifespan Urgent Care, the credit card on file will be charged up to Tier 3 price. for payment of the balance due.

Complaints and Questions

If you have questions that have not been covered by this information or would like to make a complaint, please contact our billing office at 1-800-884-6966.

About this Policy

Policy title: Lifespan Urgent Care Billing and Collection Policy
Policy #: UC10012019
Effective date: 11/01/2019
Revision date: None
Review Responsibility and Final Authority to Determine Reasonable Effort has been made: Director of Customer Service/Self Pay