BILLING

Click the links below to view billing information:

The billing team here at Platte River Medical Clinic is focused on providing top notch customer service while guaranteeing that payment from the patient and insurance companies occur in a timely manner. We are here to help you with any questions you may have regarding your bill or your specific insurance policy. For any billing inquires please send a secure message to our billing team through the patient portal.

Or Call at 303-659-7600
Please explore our website to find out more about your insurance and our policies.

Financial Policy:

Thank you for being a part of Platte River Medical Clinic. We believe that good care for you and your family starts with good communication, and we have created this policy to help our patients understand the responsibilities that they have for payment of our fees. If at any time you have questions or problems with our fees or payment process, please don't hesitate to contact our Billing Staff at 303-659-7600 option 4 or email billing@platterivermed.com.

We expect that our patients promptly pay all charges that we present to them. If we present a charge to you, it means that we have billed your insurance and the remaining amount is your responsibility. Your insurance company should provide an Explanation of Benefits (EOB) to you regarding charges, payments and your responsibility. If you disagree with the payment or processing of your charges this would be something to discuss with your insurance company.

For our uninsured patients a 25% discount will be offered and must be paid in full at the time of service. Anything that cannot be paid in full at the time of service will not be eligible for a discount and will be billed at the full amount, this includes previous balances.

Payment for our services is due at the time they are provided to you. This includes compayments, coinsurance and deductibles and any charges which have remained unpaid. We will send out statements via mail following your visit. As a courtesy to our patients, we bill your insurance which constitutes an extension of credit.

If no payments or arrangements have been made on your account we will consider turning the account over to our collection Agency, American Collection Systems. Collections are always a last resort, so please help us to help you maintain your account. Thank you!

To Our Cash-Pay / Uninsured Patients,

We have implemented new procedures to accommodate our patients that do not have insurance and will be paying out-of-pocket for their visit and services. We require same-day payment and will no longer be billing for cash pay services. However, we are offering a 25% discount for any charges that are paid at the time of service.

We do require payment for the office visit prior to being seen. The office visit is based strictly on whether you are a new patient or established patient. Any extra charges, such as labs, tests and/or procedures need to be paid prior to leaving the office to take advantage of the discount.

We offer this discount to help out patients with their medical expenses and do appreciate the opportunity in taking care of you and your family.

Sincerely,

Platte River Medical Clinic Staff

FAQ's

Why does the doctor's office need my personal and health insurance information to get paid?

The doctor's office staff uses this information to confirm your coverage, verify eligibility and to send the health insurance company a request for payment of your medical bill. Be sure that you've updated your policy and your demographics at every appointment because much of this information may have changed since your last visit.

How is my doctor's office paid?

You should pay your co-payment at the time of your doctor's appointment. We will make every effort to seek payment from your health insurance company for the amount owed under your policy. If your insurance determines you owe more than your co-payment, such as a co-insurance or deductible, we will then bill you for the remaining balance.

What is a co-insurance?

Co-insurance is a portion of your bill, sometimes in addition to a copay, that you must pay. Co-insurance is usually a percentage of the total medical bill — for example, 20%. Essentially, if you have a coinsurance you will be splitting the cost of your healthcare with your insurance carrier.

What is a deductible?

A deductible is the amount that you most pay towards your medical treatment before your health insurance company starts to pay. Deductibles vary for each plan, and might be adjusted depending on how many individuals are on your plan - for example, $500 per individual or $1500 per family. In most cases, the deductible starts over at the beginning of each calendar year.

What is a "coordination of benefits" form?

Many health insurance companies require you to fill out a form that tells the company whether you or another family member have other health insurance. Your health insurance company needs this information to work with other insurers to determine which company pays for what service. It is important that you fill out this form and return it to your health insurance company. Otherwise, your medical bills may not get paid or payment may be delayed.

I have recently changed insurance, but do not have a copy of my new card yet. What should I do?

If you have received correspondence from your new insurance company with your individual plan, identification number and copayment amount on it please provide a copy of this letter to the office. If not, please contact your new insurance company directly or your H.R. contact to obtain this information.

Commonly Used Insurance Terms

May 9, 2011

Benefit: The amount your plan will pay a physician, group, or hospital, as stated in your policy, toward the cost of service of procedure performed by the physician.

Claim: The form that the physician files with a health insurance company that details the services and procedures performed by the physician, on your behalf, and other pertinent data that is required by the health insurance company to receive payment.

Co-payment or Copay: The part of you medical bill that you must pay each time you visit the doctor. This is a pre-set fee determined by your health insurance policy.

Co-insurance: The part of your bill, in addition to a copay, that you must pay. Co-insurance is usually a percentage of the total medical bill — for example, 20%.

Deductable: The cost you must pay for the medical treatment before your health insurance company starts to pay — for example, $500 per individual or $1500 per family. In most cases, a new deductable must be satisfied each calendar year.

Explanation of Benefits (EOB): A written statement to a beneficiary, from a third party payer, after a claim has been reported, indicating the benefits and charges covered or not covered by your insurance plan. Remember, your EOB is not a bill.

Primary Health Insurance Company: The health insurance company that is responaible to pay your benefits first when you have more than one health insurance plan.

Secondary Health Insurance Company: The secondary health insurance company is not a first payer of your claims. The remaining claim balance will be sent to a secondary health insurance company, if provided, after a payment is received by the primary health insurance company.

Accepted Insurances

  • Aetna
  • Beech Street
  • Blue Cross Blue Shield
  • CIGNA/Great west
  • Cofinity
  • Coventry
  • Guardian
  • Health Net
  • Humana
  • Medicaid
  • Medicare
  • Medical Mutual of Omaha
  • Multiplan
  • Pacificare
  • Principal
  • PHCS
  • Self Pay
  • TriCare
  • United HealthCare
  • Workers' Compensation
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