Office: 535 Ocean Avenue, Portland, Maine 04103     Phone: (207) 518-6000     Fax: (207) 518-6001

Billing FAQ’s

Will you bill my insurance?
Women’s Wellness Comprehensive Care will bill your insurance as a courtesy to you. We need complete insurance information to honor that commitment. However, you are responsible for full payment of any unpaid amounts billed to your insurance carrier.

What are copays, coinsurance and deductibles?
A copay is a specified dollar amount you pay when receiving certain treatments, services, or supplies.

  • Coinsurance is the percentage of covered charges for which you are liable.
  • The deductible is the specific dollar amount for a covered treatment, service, or supply that a member is responsible to pay before benefits are payable under the policy.

I paid my copay at the office. Why am I getting a bill for my copay?
After your health insurance plan processes the claims, there may be additional copayments or coinsurances you may have. You should be receiving an Explanations of Benefits from your insurance regarding your visit with our office.

What are my payment options?
We expect payment in full upon receipt of your statement for services provided at Women’s Wellness. We accept cash, check or credit card (VISA, Discover and MasterCard).

If full payment is not possible, please contact our billing office 207-518-6041.

Does Women’s Wellness participate with my health plan?
“Participation” means that Women’s Wellness has an agreement with an insurance company health plan to provide for its members. Contact your health insurance plan to make certain that our office is a participant within your plan’s network.

What if Women’s Wellness does not participate with my health plan?
If you are a member of a health plan in which our office does not participate, you may still receive services at Women’s Wellness. These services are considered out-of-network and may not be covered by your insurance carrier. You are responsible for full payment of the account if the balance is not covered by your health plan.

Why did I receive a bill from NorDx?
Women’ Wellness offers to have your lab drawn here at our office at your convenience. If you had a lab work done with our office, you may receive three bills: one from Women’s Wellness for your office visit, one for the lab work, and one from the pathologist reading the lab tests. Please call NorDx at (207) 396-7830 or toll free at (800) 773-5814 if you have any questions regarding your bill with them.

Why am I receiving a bill from the hospital after my surgery?
If one of our providers rendered your surgery at the hospital, you will receive two separate bills. One bill reflects the hospital charges and/or facility fees, and the other bill reflects charges from the provider of service. If, however, services are rendered at a physician office, then all charges are combined onto a single statement.

Why didn’t my insurance pay on my claim?

There are several reasons why insurance did not pay your claims. Here are a few of them:

  • Your yearly deductible may not have been met.
  • Your doctor/facility was not in your network.
  • Your visit was not a covered service.
  • They may have sent you a letter requesting more information; mostly for Coordination of Benefits.

*Please contact your health insurance regarding this issue.

What if my insurance company does not authorize or cover services?
You will be responsible for charges your insurance company does not authorize or cover. It is recommended that you contact your Primary Care Provider to discuss whether to receive the service.

What should I do if my insurance sends its payment directly to me?
Insurance payments for claims that are sent directly to you, whether from primary or secondary insurance companies, should be used to pay outstanding charges to Women’s Wellness. Patients are financially responsible for all outstanding charges. Either deposit the insurance check and send us a personal check, or forward the insurance check as soon as possible.

Insurance
Women’s Wellness Comprehensive Care participates with most insurance plans. You may want to contact your insurance carrier prior to your appointment to confirm that our group participates with your plan. Please bring your insurance card with you on the day of your appointment. Co-payments are required at the time of visit. For your convenience, insurance claims will be submitted by our staff. Be aware that your insurance plan might not cover the total charge. If there is a balance on your account after the insurance company makes payment, you will be responsible for this balance.

Referrals
If your insurance plan requires referrals, it is your responsibility to contact your primary care provider so this can be completed prior to your appointment. If your claim is denied by the insurance company because a referral was not obtained, you may be responsible to pay for that visit.

Payment Policy
If your insurance plan requires a co-payment for your office visit, this payment is expected at the time of service. We accept Mastercard, Visa, Discover, checks and cash. If you are not covered by an insurance plan, please call our office to discuss payment options prior to your appointment.

We ask that you pay your bill within 30 days of receiving a statement from Women’s Wellness. We also ask that patients with credit cards sign a consent form before surgery giving your credit card company permission to pay any outstanding balance that remains after your insurance pays its part of your bill.

If you believe your services were paid incorrectly, please contact your insurance carrier. If you believe we billed you or your insurance company incorrectly, please call us and we will make every effort to clarify your bill – or to correct the problem quickly if we have made a mistake.

Self-Pay (Uninsured or High Deductibles)
If you do not have health insurance coverage, we offer 20% discount at the time of service. We ask that you pay for office visits at the time of service and pay the surgery fee before your surgery date. If you do not believe you can pay this amount, we will review your situation with our billing office, which will then make the final decision.

Cancellation/ No Show Policy for Doctor Appointment
We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. However, when you do not call to cancel an appointment, you may be preventing another patient from getting much needed treatment. Conversely, the situation may arise where another patient fails to cancel and we are unable to schedule you for a visit, due to a seemingly “full” appointment book. If an appointment is not cancelled at least 24 hours in advance you will be charged a fifty dollar ($50) fee; this will not be covered by your insurance company.

Unpaid Bills
We bend over backwards to help our patients to be seen in our office in an affordable way, but we must also collect payment that we believe has been fair and accurate. Despite this, our first concern is still your health, and we understand that there are times when financial difficulties arise. If this occurs, please call our billing office (207-518-6041) to  negotiate your bill and arrange an easier payment plan. Our staff will work compassionately to help you through your hardship. If you do not call us, though, and do not answer our calls or letters to you, then we will eventually send your account to a collection agency. Aside from the annoyance of being pursued by an impersonal agency, the agency and the office will add a fee equal to 47% of your outstanding balance. It is always better to deal with Women’s Wellness directly.

For questions regarding your account or other billing related issues, please call our billing office at 207-518-6041.