Insurance and Payments
Mail payments to:
Bluffton Physician Services, LLC
P.O. Box 4853
Belfast, ME 04915-4853
For credit and debit card payments, call (877) 455-4778.
To ensure there are no surprises, patients should contact their insurance company after an appointment is scheduled at BMG. By calling ahead, patients can ensure the services they will be receiving are covered under their plan and they are not held responsible for large, out-of-pocket expenses. Please note that some insurance companies pay a fixed amount toward a certain procedure while others pay a percentage of the overall cost of the procedure.
BMG submits patient claims directly to the insurance company. However, patients are responsible for payment of services rendered regardless of the type of insurance. This includes:
- Co-payment at the time of service. VISA, MasterCard (credit and debit), checks and cash accepted
- Deductibles and co-insurance payments
- Any remaining balance after the insurance payment
Patients will receive a statement after BMG has received payment or a response from the insurance company. This statement is the first notification a balance is due, and full payment is due upon receipt.
BMG will file secondary insurance claims as a courtesy to patients if the insurance information was given at the time of service. If the balance is not paid within 30 days from the date of secondary insurance filing, BMG will bill the patient the balance, unless otherwise restricted. Medicaid patients will receive a statement unless they are eligible for benefits, do not have a deductible or have other insurance.
Patients presenting as uninsured and/or without coverage by a third party source are eligible for a reduction in charges through the self-pay discount policy.
Medicare Assignment Program
BMG participates in the Medicare Assignment program. Patients in this program are responsible for 20 percent of the Medicare-allowable portion of the cost of their services, with the exception of laboratory services, which are covered 100 percent. Medicare patients are also responsible for deductibles and noncovered services. Although BMG will bill Medicare for charges and also file claims with secondary insurance providers, payment for noncovered fees is expected at the time of service.
Medicare and Medicaid Noncovered Services
Medicare and Medicaid only pay for tests and procedures considered medically necessary. Prior to services being rendered, BMG is required to identify Medicare and Medicaid noncovered services and issue an Advanced Beneficiary Notice of Non-Coverage form (Medicare) and/or a Waiver of Liability form (Medicaid) to notify patients of their financial responsibility.
- The patient may sign the form, have the test or procedure performed and be billed for it.
- The patient may refuse to sign the form, have the test or procedure performed and be billed for it. If the patient refuses to sign the form, a witness must also sign the form to indicate that the form was offered but refused and permission was granted for tests or procedures to be performed.
Medicare and Medicaid patients will not receive a statement until after payment or a response has been received from Medicare and/or Medicaid.
Denial of Claims
BMG will not become involved in disputes between patients and their insurance company regarding deductibles, co-payments, noncovered charges, secondary insurances and usual and customary charges, other than to supply factual information as necessary. Patients are responsible for timely payment of their account.
Credit Arrangements/Payment Plans
Reasonable attempts will be made to communicate with patients regarding their accounts and to work with them to reach agreeable resolutions within federal guidelines and company policies. Patients are encouraged to pay in full, but if they are unable, a budget plan can be created to pay the outstanding balance over time. The minimum balance must be greater than $100. If the balance is less than $250, it must be paid within three months, and if it is greater than $250, the balance must be paid within six months. Individual payments must be greater than $25 per payment period.
If full payment of the outstanding balance presents a severe financial hardship, patients should call the BMG administrative office at (260) 353-2002.
Accounts must be resolved no later than 60 days from the date of service. Resolution of an account means:
- The account is paid in full.
- Acceptable payment arrangements have been made.
BMG reserves the right to pursue other legal means of collection. Patients/guardians are responsible for all charges incurred in an effort to collect past-due balances, such as attorney and
Worker's compensation claims require patients to bring written authorization from their employer. Failure to provide employer authorization will result in the need for full payment at the time of service.
Auto Insurance Liability
In the event of services rendered as the result of an automobile accident, LMG will file the claim with the patient's auto insurance. If this information is not obtained at the time of service, charges will be filed with the patient's medical insurance. If the claim is denied, the charges become the patient's responsibility. LMG will not become involved in disputes between patients and their insurance carrier.
Indiana law permits a fee to be assessed for the copying of medical records. The fee must be paid in full and a consent form signed by the patient or legal guardian prior to the release of records.