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Insurance Information

What to bring with you during Registration:

Registration Information
•Registration Form (completed)
•Picture ID (Driver's License)
•Social Security Number
•Emergency Contact Information

Insurance Information
•Insurance Identification Card
•Medicare Card
•Medicaid Card

Accident Information
•Worker's Compensation
•Employer's address
•Liability carrier address
•Date and time of accident
•Copy of Liability Insurance Card
•Attorney representing case


Preferred Provider Organization (PPO):

Please check your Policy Booklet to ensure that Star Valley Medical Center and your physician participate in your health care plan (in-network). Your plan may have special requirements, such as, a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital.

Health Insurance:

We request that you bring your insurance identification card each and every time you come to Star Valley Medical Center. This will enable us to file your claim properly, as most plans have special requirements. Please remember that your insurance policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital bill.

Medicare:

We request that you bring your Medicare card and Supplemental Insurance card each and every time you come to Star Valley Medical Center. This enables us to verify eligibility and process your Medicare claim. Deductibles and co-payments are the responsibility of the patient.

If you have questions about Medicare, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.


Medicare Advantage Plan:

Medicare Advantage Plans are “not” traditional Medicare.

They are a Medicare Replacement Plan, "NOT" a Medicare Supplement. These claims are sent to the insurance company noted on your card. We request that you bring your Medicare Advantage card each and every time you come to Star Valley Medical Center.

Other than Emergency Care, Star Valley Medical Center is “NOT” required to accept your Medicare Replacement Plan. At this time, we will accept your Medicare Advantage Plan, on a day-by-day basis. However, we reserve the right to NOT ACCEPT your Medicare Advantage Plan in the future.


Medicaid:

We request that you bring your current Medicaid card each and every time you come to Star Valley Medical Center. This will enable us to obtain the necessary information from your Medicaid card and send it to the Department of Health and Human Services. Please remember that it is your responsibility to provide us with your Medicaid information. If this is not provided, you will be held financially responsible for payment of your hospital bill. We participate in the Wyoming and Idaho Medicaid programs.

Frequently Asked Insurance Questions:

1. What is an “EOB” Explanation of Benefits?
A: A statement sent from the Health Insurance to the patient listing services that were billed and how they were processed listing deductibles, co-insurance, amount insurance may have paid and patient due amount.

 
2. What does Deductible, Co-insurance and Co-pay mean?
A: Deductible: provisions that require the member (patient) to accumulate a specific amount of medical bills before benefits are provided by the insurance company.

Co-insurance: after deductibles are met, the plan begins paying a percentage (usually between 50%-90%) of covered charges. The remaining amount, called co-insurance, is paid by the member (patient).

Co-pay: a co-pay is usually a fixed fee ($10, $15, $50, etc) the member (patient) pays to providers (Doctor/Hospital) at the time covered services are performed. The level of co-pay is determined by the insurance benefit option.
 

3. What does “PPO” mean?
A: Preferred Provider Organization are physicians, hospitals, health care providers and clinics who sign contracts with PPO systems to provide care to its insured people, agreeing to accept the PPO fee schedule and guidelines.  


4. If Star Valley Medical Center does not participate in my healthcare plan (non-network), am I responsible for the out-of-network charges?
A: Yes, it is your responsibility to make sure the requirements of your plan have been met. (example is pre-certification of a procedure or visit) Check your policy booklet to ensure that Star Valley Medical Center and your physician participate in your Health Care plan.  
 

5. Can I set up a payment plan?
A: Yes, we have payment guideline options we follow:Payment in full or ,monthly payment options when you need more than 90 days to pay your account.
 

6. I gave you my insurance card before, why do you need it again?
A: We request that you bring your “current insurance identification card” each and every time you come to Star Valley Medical Center. This will enable us to file your claim properly, as most plans have special requirements and insurances change.
 

7. What does “third-party liability” mean?
A: Examples of third-party liability are auto accidents, falling in a parking lot or any other incident where someone else may be liable for the charges.


8. What is SAM (self-administered medications)?
A: Medicare has a list of drugs they consider “self administered” and these drugs are excluded from coverage in the Medicare program. A drug is considered self-administered when it is self-administered by more than 50% of Medicare beneficiaries on an outpatient basis. This determination is made on a drug by drug basis. When given in an outpatient setting, these drug costs are the responsibility of the patient.
 

9. What do you mean when you ask for the Guarantor number or the Account number?
A: Star Valley Medical Center does “Guarantor” which is “family” billing. That means the “Guarantor” will receive “one” Guarantor number. This number is located in a box in the top right of your statement under the box that shows your name.

However, each time you or a family member is seen at Star Valley Medical Center, a separate “account number” is assigned to each patient. These “account numbers” are located in the body (middle) of your statement with the patient name, date of service and summary of charges. The statement is sent under the “Guarantor” name and this statement will include each separate current “account” number for each patient in the family that was seen.
 

10. Why didn’t insurance pay my bill?
A: Star Valley Medical Center will file your claim with the information you give at the time of Registration. It is very important that you bring your “new/current” insurance card, Medicare card, and Medicaid card at each and every visit to ensure accurate filing of your claim. If your insurance has not paid, you will receive a statement for your services. Please contact the Business Office. Insurance companies often times request additional information from the patient in order to process the claim. We may ask you to contact your insurance company to resolve any delays in processing your claim.

Please remember, as a courtesy, we submit your claims to your insurance company for you. However, our professional services are rendered to you and not the insurance company; therefore, you are directly responsible for the cost of your treatment.