Comprehensive Care in One Convenient Location

An Explanation of Our Billing Process

Copyright © 2023 Columbia Medical Practice. All rights reserved.

Participating Insurance Carriers 2023

CMP is participating with the following insurance plans:

• AARP Medicare Advantage Choice (United Healthcare)
  
• AARP Medicare Advantage Patriot (United Healthcare)
  
• Aetna HMO & PPO Commercial
  
• Aetna Medicare Advantage
  
• Aetna Better Health of Maryland MCO  (Pediatric Dept Only)
  
• All Savers Alternate Funding Plan (utilizes UHC Choice Plus network)
  
• Amerigroup MCO (Pediatric Dept Only)
• Carefirst-All Commercial products
  
• CareFirst Community Health Plan (formerly University of MD Health Partners)
• CareFirst Advantage Dual Prime MC Advantage (formerly UMMS MC Adv) -(Medicare/Medicaid)
  
• Cigna HMO & PPO commercial
  
• Cigna Achieve Medicare HMO
  
• Cigna Preferred/Cigna Preferred Plus Medicare HMO
  
• Cigna Total Care Medicare HMO
  
• Cigna Traditions Medicare HMO 
  
• Cigna True Choice Medicare PPO 
  
• Employer Health Plan (EHP)
  
• First Health
  
• Johns Hopkins Advantage HMO & PPO
  
• Kaiser Flex Choice Plan (PLAN USES MULTIPLAN/PHCS Network)
  
• Maryland Physicians Care MCO (Pediatric Dept Only)
  
• Medical Assistance
  
• Medicare Part B
  
• Multiplan/PHCS
  
• Priority Partners MCO
  
• Railroad Medicare Part B
  
• Tricare (Prime HMO, Select PPO & Tricare-For-Life)
  
• United Healthcare Commercial PPO, MDIPA & Optimum Choice
  
• United Healthcare Balance & Value Gold/Silver/Bronze (State Exchange)-CMP must be PCP
  
• United Healthcare Medicare Advantage Dual Complete (Medicare/Medicaid)
  
• United Healthcare Community Plan MCO
  
• US Family Health Plan

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Note: CMP can see patients in the Aetna Medicare ESA (out of area) PPO Plan since members receive full benefits whether in or out‐of‐network

If You Are Not Covered by Insurance

The department manager can provide an estimated fee for services not covered by your insurance or if you do not have insurance. Please be aware that the final charges will depend on the actual services provided. You are responsible for the full cost of your care. As a self-pay patient you will also be asked to sign an agreement to pay for services received. Payment must be made at the time of service.

Payment Options

If you have a financial obligation to CMP after your insurance has fulfilled its financial responsibility, you will be expected to pay the balance due. You will receive a monthly Patient Statement showing all open balances.

If you cannot pay your patient balance in full, it may be possible to arrange a Payment Plan. The Department Manager or Billing Office can provide information about available monthly Payment Plans.

Refunds

Once all charges and payments have been posted to your account, if the amount you have paid exceeds the actual charges, you may be eligible for a refund. We routinely review accounts and will issue a refund when appropriate.

If you request a refund, your account will be researched to determine whether there are any open balances. If so, the credit amount will be applied to those balances. If you have no other financial obligation to CMP, a refund will be processed.

If You Are Covered by Insurance

Please make sure you understand your insurance coverage and, if you are in an HMO, whether CMP is "in network." You may still be treated here if you have an out-of-network option or elect to self-pay. If you have an out-of-network option, your eligibility for insurance coverage may decrease, and your personal financial responsibility may increase. We will attempt to verify your insurance eligibility and coverage prior to your visit, but we depend upon you to understand your insurance plan and the rules affecting coverage.

When you arrive, you will be asked to pay any applicable copay. Most HMO plans require a separate copay to be collected for each department you visit. In an effort to protect your identity, you will also be asked to present a copy of your driver's license or legal identification and current valid insurance card as proof of insurance.

If you have any open balances, you will be asked to pay them at the time of your visit. Our billing staff is available to answer any questions regarding your bill or insurance payments.

If your insurance carrier has changed since your last visit, please notify the front desk personnel in order to prevent delay in processing your claims. We will also require a referral to a specialist, pre-certifications, or authorizations if necessary.

We will file a claim with your insurance for physician visits and any ancillary services approximately 1-2 days after your visit. Your monthly patient statement will show all amounts due. If you have a patient balance due on one or more accounts and insurance pending on other accounts, your statement will reflect both patient and insurance pending amounts. To lower administrative costs for your care, we require prompt payment of all amounts for which you are personally responsible.

Patient Demographic Information

It is critical that your information with us is up-to-date to ensure your billing is accurate and complete. This information should include the following:

• your name, address & telephone number,
• the name, address & telephone number of the person responsible for your bill,
• the name of your insurance company, group number, plan number or other identifying numbers, and
• your insurance company's claims filing address & telephone number.