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Physician Network Billing and Insurance

Home » Patients and Visitors » Billing and Insurance » Physician Network Billing and Insurance

About Your Physician Network Bill

Northern Medical Group understands that health insurance and billing can be confusing.

That is why we are here to provide assistance with your billing experience.  We are committed to providing an efficient, timely and patient-friendly process.  Together, we can ensure that your experience is as easy as possible.  You will receive a separate monthly billing statement for each practice you have visited.

Hospital-Based Billing Questions and Answers

Several of the Northern Medical Group clinics are classified as Northern Regional Hospital-based outpatient clinics. If you are covered by Medicaid, Medicare or a Medicare Advantage plan, have a managed care insurance plan, or do not have insurance, your out-of-pocket costs for seeing a physician and receiving services in a hospital-based outpatient clinic may be more, compared to the out-of-pocket cost for the same services in a private physician office.

Click here for a list of Frequently Asked Questions regarding Hospital-Based Outpatient Clinics >>

Customer Service Office

If you need to speak with someone regarding a Northern Medical Group Physician Practice or Hospitalist bill you may call our Centralized Customer Service office at 336-719-7458 or Toll Free at 1-888-626-0113.  

The Customer Service Office is conveniently located within our main hospital entrance to the left of our lobby. It is open from 8:30 am – 5:00 pm, Monday – Friday. We also have a Customer Service email that you may inquire about billing questions. The email address is customerservice@wearenorthern.org. We will be happy to assist you with any questions you may have.

For your added convenience, we offer a payment drop off box located on the hospital campus. The drop off box is located at the Patient Discharge Entrance. To access the box, enter the hospital driveway on Rockford Street, closest to the stop light at Rockford and Worth Streets. The drop box is conveniently accessible from your vehicle on the left side of the driveway.

Insurance

As a courtesy to our patients, we will file your current active insurance for services received at one of our offices. Most insurance companies resolve their part of the bill within 60-90 days. If payment is not received in this timeframe, we may request your assistance in resolving the bill. You will be responsible for office/specialists co-pays prior to service and services not covered by your insurance. 

Insurance Plans

Northern Medical Group contracts with most major health insurance plans, as well as Medicare and Medicaid.  The following is a list of the most common insurance plans with which we participate. If you do not see your plan, please call your insurance company to see if we participate with your plan.

Attention NC Medicaid Beneficiaries

  • AmeriHealth Caritas NC
  • Anthem
  • BCBS of NC
  • Blue Medicare
  • Cigna
  • Healthy Blue (Blue Cross Blue Shield of NC)

  • Humana (commercial)
  • Humana Medicare
  • Medcost
  • Medicare
  • NC & VA Medicaid
  • United Healthcare

Payment

We require our patients to pay any office/specialist co-pays prior to service. Any other balances owed will need to be paid at time of service or a payment arrangement will need to be set up.  A down payment may be required for high cost services. You may pay your bill online here.

Uninsured Patients

Northern Medical Group offers all uninsured patients a 35% discount off their total billed charges if paid at time of service or within 30 days of service. Any patient that receives Financial Assistance or turns in retro insurance will no longer be eligible for the self-pay discount.

Financial Assistance

Northern Medical Group is committed to providing outstanding healthcare to all members of our community regardless of their ability to pay. We understand that unexpected medical expenses can generate a concern for you and your family. That’s why we offer free care to patients who qualify for our Financial Assistance program.

All applicants must complete a Financial Assistance application, be screened for Medicaid Eligibility, provide proof of income and provide copies of household bills. Proof of income can be a copy of a recent pay stub, W2 Form, tax return, Social Security or Disability verification, public assistance, alimony, child support or  education assistance. Applicants that have income at or below 200% of the Federal Poverty Guideline will receive 100% discount for eligible services performed by one of our physicians.

If you have any questions regarding Financial Assistance or need help with your application, please contact the office.

Download the Financial Assistance Application >
Solicitude para Asistencia Financiera >

FAQs

Hospital-based outpatient clinics are considered part of the hospital; “private” physician offices are not (generally, these are smaller physician offices out in the community). Clinics located miles away from the main hospital campus may still be considered part of the hospital. Hospital-based outpatient clinics are subject to stricter government rules, making them more complex and more costly to operate. When you see a physician or receive services in a hospital-based outpatient clinic, you are being treated within the hospital rather than the physician’s office.

According to Medicare billing rules, when you see a physician in a private office setting, all services and expenses are bundled in a single charge. When you see a physician in a hospital-based outpatient clinic, physician and hospital charges are billed separately. Providing services in a hospital-based outpatient clinic cost more and depending on your insurance plan, may result in greater out-of-pocket expenses for you.

Making informed healthcare purchasing decisions is important. Ask your insurance company if your benefit plan covers facility charges in a hospital-based outpatient clinic and how much of the charge is covered or will be applied to your deductible.

In a hospital-based outpatient clinic, some patients will receive two (2) separate bills for services provided in the clinic – one from the doctor and one from the hospital. Patients with Medicare, Medicaid, and some commercial payers, will be required to pay two copayments for the clinic visit – one copayment for the physician visit and one copayment for the hospital visit. Medicare patients will be required to pay a co-pay for professional services and coinsurance and/or deductible amounts for hospital services.

The following are the hospital-based locations under Northern Regional Hospital: Northern Cardiology
Northern Family Medicine
Northern Gastroenterology
Northern General Surgery
Northern Obstetrics & Gynecology
Northern Orthopaedics
Northern Pain Management
Northern Pediatrics
Northern Pulmonology (coming Feb. 2021)
Northern Urology Other locations will be included as Northern Regional Hospital continues to expand services to
meet patient needs.

Northern Regional Centralized Customer Service Office. If you have questions, please them at 336-719-7458 or Toll-Free at 888-626-0113.

About Billing and Insurance
Understanding Your Hospital Charges & Costs
ClearBalance Loan Program
Options for the Uninsured
Physician Network Billing and Insurance

830 Rockford Street | Mount Airy, NC 27030

(336) 719-7000

nrhinfo@wearenorthern.org

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