Insurance

Dual Coinsurance – Provider-Based Billing

For our patients on Medicare, Medicare Advantage, Medicaid and Tricare

Golden Valley Medical is a provider-based clinic, which means we are owned and operated by a hospital. As a result, your insurance mandates that facility charges incurred in the clinic will be charged and billed separately. This means that your provider’s claim representing professional charges is billed separately from the facility claim resulting in dual coinsurance amounts owed by the patient. Also, please note, your insurance requires that all lab tests drawn at our facility have to be billed by Golden Valley Memorial Healthcare.

Receiving care at our clinics will result in a hospital coinsurance amount, as well as a provider visit coinsurance amount for outpatient services and/or procedures. If your secondary insurance does not cover the coinsurance, Golden Valley Memorial Healthcare will bill you for these amounts after your payor processes the claim. The estimated hospital coinsurance amount is $40, but will vary depending on the services and treatments we provide. It may be less, but it may be more.

For our patients with commercial insurance or other coverage, such as BCBS, Aetna, UHC, etc.

As a provider-based clinic, specialist visits, labs and radiology imaging are billed as outpatient hospital services, so there will be outpatient facility charges separate from your clinic physician/provider charges. There are no hospital deductible and/or coinsurance amounts due for visits to your primary care provider, but the deductible and/or coinsurance amount will apply if you have lab or radiology imaging. As stated above, your deductible and coinsurance will apply. If you wish to have your lab specimens sent to another lab for processing due to your insurance policy benefits, you must speak to your provider before your labs are drawn.

Receiving care at our clinics will result in a hospital deductible and/or coinsurance amount, as well as a provider visit coinsurance amount for outpatient services and/or procedures. If your secondary insurance does not cover the deductible and/or coinsurance, Golden Valley Memorial Healthcare will bill you for these amounts after your payor processes the claim. The deductible and coinsurance amounts will depend on your insurance policy and the type of services we provide.

For our patients seeking emergency care

We provide medical screening by a physician and stabilizing treatment without delay to all individuals who come to Golden Valley Memorial Healthcare and request care, regardless of their ability to pay.

The emergency department physicians are private doctors we contract to provide care to our patients, but are not employed by Golden Valley Memorial Healthcare. They will bill you separately for their services and are out-of-network with commercial insurance plans.

If you receive a bill from Golden Valley Memorial Healthcare, it will only pertain to the charge incurred for the use of the emergency department treatment area, technical and ancillary personnel, supplies and equipment. It will not include the emergency physician’s fee.