Frequently Asked Questions
Healthcare is often confusing and expensive with answers that are hard to find. We understand.
Riverview Health has made the choice to provide honest billing and dedicate ourselves to customer service. We do not balance bill because we think it is ethically wrong and violates our contract with your insurance company. We also do not “up-sell” our emergency room. We compiled feedback from you to provide answers to the most common questions.
An urgent care typically treats non-life-threatening conditions, such as common colds, flu, strep throat, lacerations and more.
An emergency room treats conditions in need of immediate attention, such as chest pain, abdominal pain, dehydration, complex fractures and much more.
Selection of the right facility can make a big difference in the financial outcome of your visit. Choosing an emergency room and not having an emergency means you will overpay for your treatment. Selecting an urgent care and needing an emergency room will add unnecessary costs, but more importantly, you may waste valuable time by being transferred to a facility that is capable of treating your condition.
Riverview Health Emergency Room & Urgent Care was created on the premise of solving this problem. Each facility is equipped to handle the seriousness of any emergency while being able to bill what turns out to be lower acuity needs at urgent care billing rates. This means that as a patient you do not have to try to decide where to go on your own. The answer is to choose Riverview Health Emergency Room & Urgent Care. By doing so you can ensure your bill will only reflect the level of care you require to treat your condition. Why is this significant? Because 44-65 percent of ER visits nationwide could have been treated and billed at urgent care rates but weren’t.
Absolutely not. We require an additional ER Acknowledgment to be obtained to make sure there are no surprises.
Our urgent care billing is available from 7 a.m. to 8 p.m. seven days a week.
Yes, Riverview Health accepts Medicare and Medicaid.
All healthcare insurance companies, including Medicare, set a distinction for first-time visits in an office or urgent care setting. The new patient charge is typically reimbursed at slightly higher rates than all following visits to the same location, due to the additional work required to set up new accounts and obtain all the necessary details to make this happen. Established patients are ones who have been seen at the office or urgent care in the past three years, so the charge for this visit is typically less than the new patient charge.
Your insurance company negotiates rates on your behalf with providers, such as Riverview Health, and agrees on rates that they think reflect the value provided to their members. Factors that determine what rates your insurance carrier agrees to include quality of providers, accessibility and patient experience.
An explanation of benefits, or EOB, is something the insurance company sends that explains what is allowed by their policies and what the associated charges are for these allowances. It is not a bill, but rather a communication from the insurance company to the patient. It may or may not correspond directly to what the final bill is from Riverview Health. The best thing to do is to wait until Riverview Health bills you and not let the EOB confuse you. Then, if you have any questions or concerns, we can help sort those out for you.
In-network means we have a contract with your insurance company and have agreed on what the rates will be for any service provided to you. Out-of-network means we do not have a contract with your insurance company in setting the rates, but as an organizational policy, we have agreed to only bill you what the in-network allowed rates are. In the emergency room, state law dictates that all patients have to be treated as if they are in-network, regardless of the in- or out-of-network status deemed by your insurance company.
If you have any questions or problems with your invoice, we are happy to help you to make sure it is correct. Sometimes this requires us to file appeals or have you call your insurance company. However, these are things we will walk you through while assisting you every step of the way. If you have any questions about your bill, your explanation of benefits, or health coverage, please contact us.
