Billing & Insurance
Your medical charges and insurance issues can be difficult to understand. We are here to help you sort it all out.
If you have questions or need help, please stop by any clinic or hospital location Monday through Friday, from 8 a.m. to 5 p.m., or call us at 1-888-838-6193 (toll-free).
Learn More About:
Billing and Payments
All insurance plans have varying requirements, which you must know in order to ensure insurance coverage. This may require you to take an active role in contacting your insurance plan regarding precertifications, referrals, etc. You are prompted to pay all amounts not covered by insurance at time of preregistration/check-in including co-pays, noncovered services, deductibles and/or coinsurance. View the list of our insurance affiliations.
- Charge information is provided upon request, within a realistic time, at no charge. Insurers can give the best estimate of the total charges not covered by insurance. For additional information, please contact Patient Account Services at 1-888-838-6193 (toll-free).
- You will receive a monthly billing statement itemizing the services received. Payment is expected within 15 days.
- Insurance claims will be submitted to insurance companies free of charge.
- Please remember, insurance policies are a contract between you and your insurance company. As a result, it your responsibility for payment of your bill.
- We realize that most medical expenses arise from unexpected accidents or illnesses and are difficult to budget. Call 1-888-838-6193 (toll-free) to speak with a patient financial planner who is able to assist you in establishing payment arrangements and/or discussing financial assistance options.
- If you are uninsured or underinsured, a patient advocate from Cardon Outreach will work with you to help you find funding for your health care expenses. Please contact Patient Account Services at 1-888-838-6193, and ask for Cardon Outreach.
Read about our Organized Health Care Arrangement.
Hospital and Physician Charges
Wisconsin Transparency Law — Act 146
Act 146 regarding health care charges went into effect Jan. 1, 2011. The act identifies requirements for releasing information by health care providers, hospitals and insurers.Charge information is provided upon request, within a realistic time, at no charge from Revenue Cycle.
Hospital charge information is available at:
- Mayo Clinic Health System in Eau Claire: wipricepoint.org
- Mayo Clinic Health System – Chippewa Valley in Bloomer: wipricepoint.org
- Mayo Clinic Health System – Northland in Barron: wipricepoint.org
- Mayo Clinic Health System – Oakridge in Osseo: wipricepoint.org
- Mayo Clinic Health System – Red Cedar in Menomonie: wipricepoint.org
Physician charge information is available for:
- Chippewa Falls
- Eau Claire
- Glenwood City
- Rice Lake
Mayo Clinic Health System consists of clinics, hospitals and other facilities that serve the health care needs of people in more than 60 communities in Iowa, Minnesota and Wisconsin. The community-based providers, paired with the resources and expertise of Mayo Clinic, enable patients in the region to receive the highest-quality health care close to home.
Thank you for choosing to receive your care with us. We have made some changes to our billing practices that we want to make you aware of.
For our patients who have Medicare and Medicare Advantage insurance, Mayo Clinic Health System in Eau Claire bills services provided at the Luther Campus as provider-based billing, sometimes called hospital-based billing.
Here are some frequently asked questions to help you understand this change:
What is provider-based billing?
Provider-based billing is a type of billing for services provided in a clinic or department considered part of the hospital. This often is the case with large health care systems. Clinics located several miles away from the main hospital campus may be considered part of the hospital. Even though you’re seeing your regular physician in a clinic setting and not actually hospitalized, your visit is billed under the hospital rather than the physician’s office.
What Mayo Clinic Health System locations are billed as provider-based billing?
You will see billing changes for most outpatient services provided at the Luther Campus at Mayo Clinic Health System in Eau Claire. This already is in effect at most Mayo Clinic Health System locations across northwest Wisconsin. Provider-based billing will not apply to the Clairemont Campus in Eau Claire.
What is different? Will I pay more for services?
In many cases, you will begin seeing a statement with charges split apart for each visit. One charge will be a professional fee (clinic charge), and the other will be a technical fee (hospital charge). The combined total charge is the same, but the components are split.
Depending on your specific insurance coverage, it is possible that some benefits will differ for these services and procedures. Some patients may have to pay a higher cost because a portion of the billed service is being charged as a hospital charge. The increase in cost is a result of the health plan’s coinsurance and deductible, so not an increase in actual fees. People with a supplement plan are not likely to see much change.
Why make the change?
This is the national model of practice for large health care networks where the hospital owns space and employs support staff who assist with patient care. It has been adopted by many medical centers locally and nationally. This benefits patients as all departments of the hospital are subject to strict quality standards and are monitored by The Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 17,000 health care organizations and programs in the U.S. Medicare and Medicaid have distinct payment programs for provider-based billing and require that we make it clear to the public which practices are part of the hospital.
Will my appointment be different?
Your clinical care will not change. You will continue to see your regular doctor and health care team, and continue to receive excellent-quality care. Scheduling appointments and tests will be handled as they have been in the past. At every visit, Medicare patients will be asked to complete an MSP questionnaire containing 10 to 15 questions. We recognize this may feel repetitive, but it is a government requirement.
Are all patients being billed this way?
No. The requirement for breaking out charges for each office visit was set by the Centers of Medicare and Medicaid. Thus, only patients with Medicare, Medicare Advantage and Tricare insurance are billed using provider-based billing. At this time, commercial insurance companies do not require this breakout.
What if I have questions?
We ask you to review your insurance benefits or contact your insurance provider to determine any changes to what your policy will cover. In addition, we have trained staff who can help answer your questions. Call 1-844-217-9591 (toll-free).
What should I ask my insurance carrier?
Making informed health care purchasing decisions is important. Ask your insurance company if your benefit plan covers facility charges in a hospital-based outpatient clinic and how much of the charge is covered or will be applied to your deductible or subject to insurance.
What can I do if I am having difficulty paying for health care services?
We offer financial assistance to help qualifying patients. Information is available by calling Customer Service at 1-844-217-9591 (toll-free). In addition, we can assist with other county, state or national programs for which you may be eligible.
Bill Pay Options
Subscribe to e-Statements to make online payments, access your past billing statements and payment history online. Log in using the subscribe link and follow the easy steps. Have your most recent statement available when you enroll. It contains information you will need to enroll. If you need assistance, please call 1-888-838-6193 (toll-free) Monday through Friday, from 8 a.m. to 5 p.m. If you receive statements for clinic and hospital services, you will need to go through the enrollment process for each. View frequently asked questions about e-Statements.
Make a payment using a credit card, debit card or checking account. Or, view your past statements and payment history.
We have a long history of providing care to patients regardless of their ability to pay. Our primary value is "The needs of the patient come first."
We provide services to meet the needs of people who are unable to pay for care. These services include:
- Helping you find sources to fund your care, including opportunities to work with outside agencies.
- Using fair and consistent collection practices that are in the best interest of all parties involved.
- Providing individualized payment plans, medical services at reduced rates or at no cost — based on your ability to pay.
- Providing emergency care to stabilize you, regardless of your ability to pay.
We can help you find alternative sources of funding for your medical care. We determine your need for charity care based on financial information and the medical services needed. The financial information includes your individual and family income, assets, employment status, family size and availability of alternative sources of payment.
If you're experiencing financial hardship, please contact Patient Financial Planning at 1-888-838-6193 (toll-free).
We may ask you to complete a Financial Assistance Application, which will help us evaluate your eligibility for charity care. Note that until your application has been reviewed and approved by our financial counselors, you'll be financially responsible for your medical care. Completing an application may not absolve you of your full financial responsibility with Mayo Clinic Health System. See our Financial Assistance brochure for more information.
Patients determined to be eligible for financial assistance will not be charged more than amounts generally billed to those who have insurance coverage for emergency or other medically necessary care. Eligible patients with insurance coverage will not be personally responsible to pay more than amounts generally billed after all payments by the health insurer have been applied. Read more about the basis for calculating amounts charged.
Please review our policies for detailed information:
Mayo Clinic Health System – Chippewa Valley
Mayo Clinic Health System in Eau Claire
Mayo Clinic Health System – Northland
Mayo Clinic Health System – Oakridge
Mayo Clinic Health System – Red Cedar
Please return the completed Financial Assistance Application and all required information to:
Patient Account Services
P.O. Box 4105
Eau Claire, WI 54702-9950