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Billing and Insurance – Frequently Asked Questions

A helpful guide to decoding your insurance coverage:

  • Premiums: The amounts you pay for your insurance policy, often deducted directly from your paycheck.
  • Deductible Are paid out of pocket each year before insurance kicks in. Each family member usually has a separate deductible.
  • Co-Payments: Are flat fees charged each time you visit the doctor or use any medical service, regardless of the cost of the procedure.
  • Co-Insurance: Requires you to pay a percentage of the total cost of care. Many plans require either co-insurance or co-pay, but some charge both.
  • Maximum out of pocket: Is the most you’ll have to spend before all of your medical bills are covered.

What is a guarantor?

A guarantor is:

  • A person or entity legally responsible for paying the remaining balance of charges for health care services after insurance has paid.
  • A responsible party to whom the organization will send billing statements and expect to work with to meet the financial obligation for the services rendered.
  • Accepts and understands terms of the admission consent form.

Who serves as a guarantor?

In most cases:

  • Patients 18 years of age or older are financially responsible and serve as their own guarantor.
  • For patients under 18 years of age, a parent or legal guardian/trustee is the guarantor.

Where may I pay my bill?

  • In person: Pay your bill at any registration or greeter desk.
  • By mail: Send your payment and billing statement to Patient Financial Services, Southwest Health, 1400 Eastside Road, Platteville, Wisconsin 53818.
  • By phone: Make a payment using your debit or credit card by calling Patient Financial Services at (608) 342-4717 or the phone number on the billing statement.
  • Online through MyChart: Access your billing account summary and pay your bill electronically through MyChart: https://mychart.ssmhc.com/mychart/.

What types of payments are accepted?

Southwest Health Center accepts cash, check, or credit card (Visa, MasterCard).

May I set up a payment plan?

  • Southwest Health Center can assist you in setting up a payment plan.
  • To speak with one of our patient accounts specialists about setting up a payment plan, call Patient Financial Services at (608) 342-4717.

Do you accept my insurance plan?

To find out if Southwest Health Center accepts your insurance plan:

  • Call the 1-800 number on the back of your insurance card.
  • Confirm that Southwest Health Center is in your insurance plan’s network.
  • Confirm that your Southwest Health Center physician is in your insurance plan’s network.

Note: if Southwest Health Center is not contracted with your insurance company, benefits may be considered “out of network” and thus not covered.

Why do you need to scan my insurance card every year if nothing has changed?

We scan all patients’ insurance cards every year to:

  • Ensure that all of your personal information in our records is up-to-date (name, address, phone, insurance).
  • Ensure that all of your billing information in our records is up-to-date so that your claims can be submitted in a timely and accurate manner.

Why must I pay a medical insurance co-pay? How much are co-pays?

  • Commercial Insurance:
    • A medical copay for group insurance is determined by the employer and insurer
  • Medicaid:
    • Copay is determined by income.
    • Co-pays are generally $1-$12.

If I have radiology services, who will bill me?

If you have radiology services, you may receive a bill from Madison Radiology for reading of a scan or x-ray.

If I need stitches removed, where do I go and is there a charge?

  • Urged to return during Urgent Care hours
  • If removed and no further care is needed = no charge
  • If removed but signs of infection or further treatment = charge