About Your Insurance Coverage
First of all, please bring your most current insurance cards to every visit!
If you are covered by insurance
You need to check with your insurance company to see if they have a contract with UAMS. If not, your services here may be “out of network.” This may decrease your insurance coverage and increase the portion that is your responsibility.
As a courtesy, UAMS will file most insurance claims. The patient must sign an Authorization and Consent form, assigning benefits to UAMS, and provide sufficient insurance information.
Please get involved with your insurance company to ensure your claims are processed quickly and accurately. If your company does not pay within 30 days of the billing date, you may be billed for the balance of your accounts. Medical College Physicians Group and the hospital refund overpayments to guarantors/insurance carriers only after all accounts are fully paid. Overpayments are applied to any outstanding balances or bad debt receivable files.
Your insurance company will probably require that you pay a portion of your doctor’s visit or hospital costs – this is your co-pay, co-insurance or deductible. We will ask you to pay this co-pay or co-insurance amounts before your appointment, procedure or admission. Without this payment, the service may need to be rescheduled.
Do you need a referral?
Most managed care plans, health maintenance organizations (HMOs) and point of service (POS) plans require that your primary care physician refer you to receive specialty care.
Each plan is different. Please find out what your plan requires and get a referral, if required. You may be responsible for payment or your appointments may have to be rescheduled if you do not have the necessary approvals.
Do you need prior approval?
Many insurance plans also require prior authorization for services. If your insurance company does not approve your care, we will notify you in advance and, if you decide to proceed with services, you will be responsible for payment.
We will file claims with any insurance company that will direct payments to UAMS Patient Business Services and the Medical College Physicians Group.
If You Are Covered by Medicare
UAMS Medical Center and the Medical College Physicians Group accept Medicare assignment of benefits; this means that we will accept the amount that Medicare allows.
After Medicare pays their portion of what they allow, we will bill your supplemental insurance directly for the remaining balance, including Medicare deductibles and co-insurance amounts.
If you do not have supplemental insurance you will be responsible for payment of the balance, after Medicare pays, within 30 days of our billing to you.
If You Are Covered by Arkansas Medicaid
If you have active Medicaid coverage, we will bill Medicaid for your services. If other insurance coverage is also available, Medicaid will not pay until the other insurer has paid or denied payment. Therefore, it is important that you keep us informed about any supplemental insurance policies you may have.
UAMS Medical Center and the Medical College Physicians Group accept Medicaid allowables as payment in full. You may have a balance if:
- Your coverage is through a spend down* category
- You receive non-covered services
- You have exhausted your Medicaid benefits
*Under the “spend down” option, you may qualify for Medicaid if you are medically needy. This means the high costs for medical expenses may be subtracted from your income, possibly making you eligible for Medicaid. You have to re-enroll in the Medicaid Spend Down Program every three months.
Many categories of Medicaid require a primary care physician (PCP) in order for your services to be paid. You must pick a PCP unless:
- You also have Medicare
- You live in a nursing home
- You live in a home for mental retardation
- You are covered by Medicaid only for a past time period
- You have Medicaid “spend down”
For UAMS patients, an on-site Medicaid Office is located on the 2nd floor of the Central Hospital (2D219) or on the 3rd floor of the Outpatient Center. Business hours are Monday – Friday 8:00 a.m. – 5:00 p.m. If you have questions please call 501-686-7680 during business hours.
Read about an unlimited benefit for Arkansas Medicaid patients.
If You Are Not Covered by Insurance
If you are not covered by insurance you may be asked to provide a deposit in advance of non-emergent care. You will be expected to pay the balance when you receive your statement for hospital and physician services.
If you cannot pay your balance in full, it may be possible to arrange a payment plan. UAMS Patient Business Services can provide information about a monthly payment plan for hospital bills. Medical College Physicians Group can provide information about a monthly payment plan for physician bills.
If the cost of your care is beyond your financial means and you are an Arkansas resident, you may request an application for financial assistance from your clinic representative, from Patient Business Services or Medical College Physicians Group.
For medical care as a result of an auto injury, you must provide Medical College Physicians Group and Patient Business Services (UAMS Medical Center) with your auto insurance information in addition to your health insurance. You are responsible for filing an accident claim with your auto insurance. Any non-covered charges are your responsibility.
If you are injured at work, UAMS must bill Worker’s Compensation. The bill will be sent directly to your employer or your employer’s Worker’s Compensation carrier. It is your responsibility to make sure that your employer completes an accident claim and the appropriate Worker’s Compensation papers to ensure prompt payment.
Charges incurred for patient care services are considered the responsibility of the patient and/or the person listed as the responsible party. UAMS will bill the guarantor for all balances not covered or paid by insurance in accordance with any arrangements that have been made. Any amounts due which are unpaid with no attempt to make payment arrangements may be referred to a collection agency.
Guarantor balances will age to the point of referral to collections, unless:
- The patient pays their balance in full
- The patient sets up monthly payment arrangements with our office
- The patient pays the minimum payment amount reflected on their statement
Patients may send monthly payments and still be at risk of referral to a collection agency if their payments are less then the minimum payment or if they have not set up a monthly payment arrangement.