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Frequently Asked Questions

Billing

We hope these frequently asked questions help to answer all of your questions. However, if you do not find what you’re looking for or have additional questions, please feel free to contact us.

What do I do if I can't pay my bill?

Gundersen Health System provides medically necessary care regardless of ability to pay. We can provide financial assistance for medical expenses that you or your family accumulate at any of our facilities. If you believe you may be eligible for Financial Assistance we encourage you to apply.

Do I have to pay my co-payment at the time of service?

Yes, you are expected to pay your co-payment at the time of service. The amount of your co-payment may be listed on your insurance card. If not, you should contact your insurance to determine the amount.

When will I receive a bill?

Providing we have received the correct insurance information, you can expect a bill once your insurance company has paid the claim and indicated you owe co-payment, coinsurance, deductible or charges for a non-covered service. If your insurance company does not respond to a claim in a timely fashion, you may also be billed.

Legally you are responsible for the bill at the time your receive services. Once you receive a statement, there will be a due date listed on the statement.

How are payments applied?

We post your payment to the oldest charges first. On your billing statement, we itemize both the charges and your payments.

Why did I receive a bill for a doctor I did not see?

Some providers may assist with your healthcare even though you may not meet them. These are the providers who read your lab results, X-rays and other test results.

Do I qualify for a discount if I do not have insurance?

Gundersen offers an uninsured discount for medically necessary services. This discount will be automatically applied to your charges. To determine if you are eligible for this discount, contact Revenue Cycle.

Who do I contact if my account has been referred to a collection agency?

Call the collection agency directly, even if you have a dispute as to the charges or why it was referred. Agencies are listed here (link to agency page with accordions for each entity, currently we all use different agencies).

Gundersen Lutheran Medical Center/Gundersen Clinic
• Americollect, (920) 682-0311 or (800) 838-0100
• Credit Bureau Data, (608) 785-2222 or (888) 378-2375
• State Collection Service, (800) 477-7474 or (608) 661-3000
• Tri-State Adjustments, (608) 788-8683 or (877) 575-6077

Gundersen Boscobel Area Hospital and Clinics

(Boscobel, Fennimore, Muscoda)

Credit Management Control, (800) 844-2358

Gundersen Palmer Lutheran Hospital and Clinics

(West Union, Fayette, Postville)
• Americollect, (920) 682-0311 or (800) 838-0100
• Credit Bureau Data, (608) 785-2222 or (888) 378-2375
• State Collection Service, (800) 477-7474 or (608) 661-3000

Gundersen St. Joseph's Hospital and Clinics

(Hillsboro, Wonewoc, Elroy)
• Americollect, (920) 682-0311 or (800) 838-0100

Gundersen Tri-County Hospital and Clinics

(Whitehall, Blair, Independence)

Credit Bureau Data, (800) 947-3604

One annual wellness visit, two separate charges?

Note: This applies to Gundersen Lutheran Medical Center only (La Crosse, Onalaska, and regional clinics not part of a regional center like Boscobel Area, St. Joseph's, Tri-County or Palmer Lutheran.

When you visit your Gundersen provider, you will be billed based on standard healthcare billing practices and insurance rules for the type of care you receive.

At an annual wellness visit your provider asks how you feel and if you have any concerns and performs an exam. One annual wellness visit is covered by many insurance plans. This might mean no out of pocket expense for you.

At a standard office visit new illnesses or injuries or follow up care of an ongoing chronic health problem are addressed. Health insurance counts each of these visits as single office visits. What insurance covers will vary widely and most plans pass some of the cost on to you.

If during your annual wellness visit you also discuss chronic health problems or new illness or injury, federal law requires us to bill these as separate visits. The result is two visit charges. Additional information can be found at this link:

One Annual Wellness Visit, Two Separate Charges

What do I do if my marital status changes?

If you have gotten married and would like to combine your account with that of your spouse, please contact us. Please note we will need permission from both parties. In cases of a divorce, please provide us with a copy of your divorce decree. Once we receive a copy of the divorce decree, we will move both adults to separate accounts. Whoever was the financial responsible person (guarantor) of the family account will continue to get two statements until the old account is paid. Any minor children will be moved to the appropriate guarantor account determined by primary physical placement or indication in the divorce decree of which parent is responsible for medical bills or who is required to carry insurance in that order.

Insurance

We hope these frequently asked questions help to answer all of your questions. However, if you do not find what you’re looking for or have additional questions, please feel free to contact us.

Should I bring my insurance card with me?

Yes, insurance needs to be verified at every visit in order to ensure timely and accurate filing of your claim.

Do I need to let my insurance company know that I'm going to be seen?

Yes, please contact your insurance company prior to your services. Your insurance company can verify your benefits, as well as in-network providers and advise if prior authorization is needed before your appointment.

Will Gundersen accept my insurance?

Please contact your insurance company to verify whether or not Gundersen Health System is in your insurance network. Payments of co-pays, coinsurances and/or deductibles are expected at the time of your appointment. We will file a claim to your insurance for the remaining balance as a courtesy. Once we receive notice that your claim has been processed, we will send you a statement of any balance that is due. If your insurance does not respond directly to us within an appropriate time frame, you will receive a statement showing the full amount due.

Will you bill my insurance company for me?

Yes, we will bill your insurance. Your insurance company will contact you if it needs additional information to process your claim

Will you file Worker’s Compensation, motor vehicle accident or medical liability claims for me?

Yes, we will bill Worker’s Compensation, motor vehicle accident or medical liability claims on your behalf. It is the patient’s responsibility to provide us with accurate information to file the claims. It is also beneficial for the patient to provide their health insurance information so a claim can be filed in the event that worker’s compensation, motor vehicle accident or medical liability claims are denied or maximum benefit limits are reached.

How will I know if my insurance company has paid my bill?

Your insurance company will send an explanation of benefits explaining how your claim was processed. Gundersen will send you a bill for any balance remaining.

What do I do if I disagree with how much my insurance company has paid?

Questions or disputes regarding insurance coverage should be directed to your insurance company.

Who do I contact if I have any questions or concerns regarding my insurance payments?

Please contact your insurance company directly. If you need to appeal this with the insurance company, they will instruct you on the procedure that you need to follow up.

What if I do not want Gundersen to release information to my health plan?

You have the right to request restrictions on whether Gundersen discloses (shares) your protected health information (PHI) to your health plan. Gundersen is required to comply with your request unless the information is required to be disclosed to your health plan to comply with law.

How do I request restrictions on Gundersen disclosing my protected health care information with my health plan?

You need to complete and sign the form titled “Request: Restrict Disclosure to Health Plan” before the service is received.

*Important note regarding the Transparency Law 2009 Wisconsin Act 146

As a patient of Gundersen Lutheran Medical Center, Inc., and/or Gundersen Clinic, Ltd., you have the right to receive information regarding charges and quality of certain health care services provided by the hospital. Please visit wipricepoint.org, or contact us at (608) 775-8660 to obtain this information.

Medicare

We hope these frequently asked questions help to answer all of your questions. However, if you do not find what you’re looking for or have additional questions, please feel free to contact us.

Why doesn't Medicare cover all medications given in the hospital setting?

Medicare does not cover medications that it identifies as self-administrable (aspirin, antacid etc.). If you get a self-administrable drug not covered by a Medicare Part B while in a hospital outpatient setting, Gundersen may bill you for the drug.

Why do I have you give you information about other insurance if I have Medicare coverage?

Medicare requires us to bill any insurance company that could have responsibility for your expenses before we bill Medicare and will not allow us to file claims until the other insurer has denied claims. Examples of this would be Worker’s Compensation, car accident, or other liability coverage.

If Medicare is your secondary health insurance plan, we are required to bill your primary insurance first.

We are required by Medicare to give you the Medicare Secondary Payor Questionnaire at each visit to determine if Medicare is primary payor for the visit.

Do I have to sign any forms before you can bill Medicare?

Yes, you will be asked to sign consent to bill and treat.

Will I have to pay anything for my services?

Yes, Medicare patients are responsible for non-covered charges, co-pays, coinsurance and deductibles. If you have coverage secondary to Medicare, we will file those charges on your behalf. Once all insurance is finished processing, we will bill you for any balances that remain.

Hospital Outpatient Billing

We hope these frequently asked questions help to answer all of your questions. However, if you do not find what you’re looking for or have additional questions, please feel free to contact us.

Thank you for choosing Gundersen Health System for your healthcare needs. As of June 1, 2013, many of our clinic locations became outpatient hospital departments. This change requires that we bill visits in those departments as hospital outpatient visits. Commonly asked questions about Hospital Outpatient Billing are answered below.

How is Hospital Outpatient Billing different than clinic billing?

Hospital Outpatient Billing is required when services are provided in an outpatient hospital department or location. It breaks out the charges for each office visit or service, with part of the total for the main provider you see (your doctor), and the rest for the place (building, support staff, equipment and other overhead). The charges add up to the same amount all patients are charged for the same service.

Are all patients being billed this way?

No. The requirement for breaking out charges for each office visit or service is required by the Centers for Medicare & Medicaid. Thus, only patients with Medicare, Medicare Advantage, Medicaid or TRICARE® are billed hospital outpatient visits. At this time, commercial insurance companies do not require Gundersen to break out charges.

How will Hospital Outpatient Billing affect my bills?

When you are seen in an outpatient hospital area, your billing statement will break out your charges for each office visit or service. Part of the total is for the main provider you see (your doctor). The rest is for the place (building, support staff, equipment and other overhead). The charges add up to the same amount, all patients are charged for the same service.

Will I pay more for services with Hospital Outpatient Billing?

Most patients insured by a government program who also have supplemental insurance will likely not pay more out-of-pocket. If you do not have a supplement, you will likely pay some amount. Check with your insurance plan to see what will be covered.

It is anticipated that Medicare patients who have Gundersen Health Plan’s Senior Preferred will not see any change in their total costs due to the benefit design of their plan.

Which Gundersen locations are hospital outpatients? Provider and facility charges are split for office visits, tests, procedures and other services in:

  • Most of the departments in Gundersen Lutheran Medical Center (La Crosse Hospital)
  • Most of the departments in Gundersen Lutheran Medical Center – La Crosse Clinic, East Building and Founders Building
  • Most of the departments in Gundersen Lutheran Medical Center – Onalaska Clinic
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Every day, Gundersen Health System delivers great medicine plus a little something extra—we call it Love + Medicine.

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