Do you have a question for us? Please click on the questions below to find answers to our frequently asked questions. If you still have questions please call any of our locations and a Pines team member will be happy to assist you.
A "deductible" is an annual expense that you must pay before your insurance benefits can begin. This amount can vary based on place of service (i.e. your doctor's office vs. a large hospital). Supplemental Insurance Plans may also cover this cost.
"Coinsurance" is the portion of the total bill (usually a percentage) that is the patient's (or guarantor's) responsibility to pay. This amount can vary based on place of service (i.e. your doctor's office vs. a large hospital). Supplemental Insurance Plans may also cover this cost.
A "Co-pay" is a set amount paid each visit, based on your insurance policy. This usually is not applied towards your deductible.
For example, on a $500 bill, your deductible might be $150, so you would have to pay the first $150. This leaves a balance of $350. Of that $350, your co-insurance might be 20%, meaning that you will have to pay an additional $70. Your insurance company should pay the remaining $280. The billing office will file this claim for you. After insurance has been billed, you may receive a bill on any remaining balances.
You should have received an Explanation of Medical Benefits (EOMB) or Explanation of Payment (EOP) from your insurance company, showing how they considered your claim. This EOMB/EOP should have a contact telephone number or web site where you can reach your insurance company for questions. Please contact your insurance company or benefits office with questions about denied claims.
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf.
After one or more Claims are submitted to a payer, the payer will determine how much the provider will be compensated for the procedures performed. When this payment is made to the provider, the patient is usually informed that the payer is making the payment by receiving a statement, called an "Explanation of Benefits", from the payer. The provider is paid and is informed as to which procedures are being paid via a statement called an "Explanation of Payments" or "EOP".
We do offer Payment Plans, or you may qualify for Access to Care. Please contact our Financial Counselors' office for assistance at 207-498-1371 or 498-1617, or 800-858-2279, ext. 1371 or 1617; by visiting our Business Office at 24 Sweden St., Caribou, ME, 04736, or by email at firstname.lastname@example.org. Our Financial Counselors are available to assist you Monday through Friday, 9 am – 4 pm. Please visit our Payment Options or Access to Care pages for more information.
Please contact our Financial Counselors' office about Access to Care, at 207-498-1371 or 498-1617, or 800-858-2279, ext. 1371 or 1617, or by visiting our Business Office at 24 Sweden St., Caribou, ME 04736. Our Financial Counselors are available to assist you Monday through Friday, 9 am – 4 pm. Please visit our Access to Care page for more information.
You may also receive bill(s) from our Hospitalist(s) if you are an inpatient. You may also receive bill(s) from any outside provider(s) that may provide consultation services or diagnostic testing, i.e., Radiologists, Anesthesiologists, Emergency Room Physicians, Ambulance Service, etc...
You are considered an inpatient when you are formally admitted to the hospital with a Physician’s order. The day before you are discharged from the hospital is your last inpatient day.
You are considered an outpatient if you are receiving emergency department services, observation services, outpatient surgery, lab tests, X-rays, or any other hospital services, and the doctor has not written an order to admit you to the hospital as an inpatient. In these situations, you are considered an outpatient even if you stay overnight at the hospital.
You may still receive a bill(s) even if you have been approved for Access to Care, because each time you come to the health center for services you are registered with a new encounter number. The new encounter number is not identified as a Access to Care Account until you contact the billing office and we verify that the services qualify under our Access to Care Program.
To speak with someone about billing and insurance at Cary Medical Center, please contact a member of the Cary Billing Team, or visit the Cary Medical Center website.