Billing Frequently Asked Questions

To help you prepare for your visit to Fletcher Allen and better understand the billing process, below are some frequently asked questions:

How does insurance work?

For every type of health care service, each insurance company calculates the amount they deem “reasonable and customary”. The dollar amount “allowed” by your insurance may be less than the Fletcher Allen charges for the service. If your insurance company does not participate with Fletcher Allen, you will be responsible for payment of any difference between the amount your insurance “allows” and the cost Fletcher Allen charges.

If your insurance does participate with Fletcher Allen, you may be responsible for payment of a co-pay for each physician seen or for a co-insurance balance, or deductible. If you have a question about why your insurance company did not pay a part of your claim, please contact your insurance company directly. 

How much will I owe ?

Fletcher Allen can provide a cost estimate of the total charges for your upcoming procedure. To obtain a cost estimate, first contact the office where you will be having the procedure to obtain a procedure code(s). A procedure code is five digits long and may contain both numbers and letters. Once you have obtained the procedure code(s) and a description of the service, our Financial Counseling department will provide an estimated cost for the procedure.

The same procedure code can also be used to obtain the “allowed” or “approved” amount for the procedure from your insurance provider and can help insurance to determine what your policy will cover.  

If I’m having an upcoming service/surgery and I have health insurance coverage, what steps should I take ?
Become familiar with your insurance plan.

Patient Check List:

• Verify your insurance benefits.  Will you have a co-pay/deductible or will there be co-insurance obligations?
• Verify with your insurance plan if a referral and/or authorization will be required for your service.
• Verify with your insurance plan if Fletcher Allen is considered in-network or out-of-network and how the benefits will vary.
• Contact Financial Counseling if payment at time of service presents a hardship to ensure financia arrangements are established.    

If my insurance company has pre-certification, prior approval or notification requirements for specific services, am I responsible for completing this task? 

The requirements and responsibility for completing pre-certification notification depend upon the contractual agreements between Fletcher Allen and your insurance company, or the requirements as defined by yourinsurance or employer group plan.  Fletcher Allen staff will assist with these requirements if we have a contract with your insurance plan. Questions should be directed to your insurance company to avoid higher deductible or co-insurance amounts. 

Is Fletcher Allen a participating provider with my insurance? 

Fletcher Allen will bill almost any insurance on a patient’s behalf, however, we do not participate with all insurance companies or their networks.  Please contact your insurance company prior to your visit for details on whether your plan will consider services provided by Fletcher Allen as In-network.  However, even if Fletcher Allen is a participating provider with your insurance, some types of service (i.e., Physical Therapy) may not be covered by your plan. If you have questions about how your insurance works, please contact your insurance company BEFORE you are seen.  

Which methods can I use to pay my bill (check, cash or credit card)? 

Fletcher Allen accepts payments made by cash, check, money order, or credit card.  We accept Visa, MasterCard, American Express and Discover Cards.

Payments may be made:

By Mail: Use the return envelope provided with your billing statement for payment

In Person: Stop by our Financial Services Cashiers Office located in the Main Pavilion, Level 3 on the Medical Center Campus
111 Colchester Avenue, Burlington

By Phone: Contact our Customer Service Department at 800-639-2719  

I went to the Walk-In Care Center at the Fanny Allen Campus, why is my insurance not paying for the visit? 

The Walk-in Care Center is considered by many payers as a family practice physician’s office.  It is not an emergency department nor designated as an Urgent Care center by most payers.  As such, a referral or authorization may be required when seeking services at the Walk-in Care Center.  Please review your benefits, and/or contact your insurance provider to determine if a referral or prior authorization is required when treatment is provided by a physician’s office other than your primary care physician.   

What if I get more than one bill? 

You may receive more than one bill for the same hospital stay. In addition to the, hospital, physician or anesthesia bills you receive from Fletcher Allen, you may also receive bills from other physicians such as, radiologists, pathologists or other healthcare professionals not employed by Fletcher Allen. These physicians bill separately for their services. Should you have any questions about the non-Fletcher Allen physicians’ bills, please contact their offices directly.

Who should I contact if there’s a change in my insurance or contact information? 

If your information changes after hospital services have been rendered, please contact our Customer Service Representatives.  If your information changes prior to service, please contact our Pre-Registration department at 802-847-5769 or 800-303-1939. 

Who should I contact if I have an insurance-related problem? 

Please contact your insurance company with any insurance related concerns.  If they are unable to assist you, please contact our Customer Service department at 847-8000; toll free at (800) 639-2719 or via email at customerservice@vtmednet.org 

How do I get information about Medicare? 

Please refer to Medicare’s website at http://www.medicare.gov/  

How will I know if my insurance company has paid my bill? 

You should receive an Explanation of Benefits (EOB) from your insurance carrier outlining how your claim was handled, including amount of payment, patient responsibility and/or denials. If there is a balance due from you, we will mail you a statement. 

Do I need to let my insurance company know that I am going to be in the hospital? 

We encourage you to check with your insurance provider prior to your hospital or outpatient visit.  Many insurance carriers require pre-authorization or referral forms prior to the day of surgery or tests. Depending upon your insurance, the authorization may be your responsibility or the responsibility of Fletcher Allen.  To ensure authorization is in place, please verify the status with your insurance company.  Most insurance companies will not pay for certain services, unless the service has been pre-authorized. 

What costs will my insurance company cover? 

Coverage varies with each insurance company. Please contact your insurance company to obtain coverage information specific to your policy. 

Will you bill my insurance company for me? 

Yes, we will bill your insurance company for you; however, you are responsible for paying any deductible, co-payment, or coinsurance amounts as specified under the schedule of benefits of your insurance coverage. Payment of these amounts will be requested at the time of service.

I got a bill from Fletcher Allen, but I've never been to your hospital or your doctors?  

Fletcher Allen provides more than just hospital, physician and emergency services. Many doctors in our community send samples to our Laboratory and Pathology Departments for testing and analysis. If your hometown physician requested the assistance of a Fletcher Allen physician, you will be billed for the services performed on your behalf. In addition to those services, many of our doctors travel to other facilities to care for patients. You may be someplace other than Burlington and receive the services of a Fletcher Allen physician.  

I can't pay the balance on the statement in full; what can I do?  

Fletcher Allen understands that with a higher balance you may not be able to pay the amount in full.  Please contact our Customer Service Department to establish budget arrangements. Without budget arrangements in place, the account may be referred to a collection agency. 

I can't afford to pay the minimum budget amount required by Fletcher Allen guidelines. How can I avoid collection agency activity?
  
Fletcher Allen has its own internal financial assistance program.  It's our private program for our patients who want to pay, but for one reason or another, need help with the bill.  Please contact the Customer Service Department for details and an application or download a Patient Assistance Application from this site.  

My account has been placed with a Collection Agency; do I need to deal with them now?  

Yes, once an account is placed with the collection agency, the agency is your reference point.  Fletcher Allen has contracted with the agency to manage the delinquent account process.  Do not ignore collection accounts, contact the agency immediately.  

I received a check from my insurance company for services provided by Fletcher Allen; how do I make sure the check is credited to the correct date of service?  

When a patient receives payment from their insurance company for services rendered at Fletcher Allen, the only way Fletcher Allen knows where to credit the payment is for the patient to send a copy of the insurance Explanation of Benefits along with the payment. Some patients simply endorse the back of the check and sign it over to Fletcher Allen. 

Other patients prefer to deposit the insurance check and send Fletcher Allen a check from their personal account.  Either way, the Explanation of Benefits must accompany the payment or the payment will be applied to the oldest account balances to prevent older accounts from aging to collections.

I was involved in an accident that wasn't my fault; isn't the homeowner's insurance or auto insurance responsible for paying my bills?    

Fletcher Allen does not become involved in any litigation regarding fault. We render health care and we bill you for it. We will bill your personal health insurance. We will send a bill to the alleged liable insurance as a courtesy to you. We do not, however, become involved in the suit.  Fletcher Allen will help you establish a budget payment plan that will keep your credit history clean while you pursue liability with or without an attorney. 

Why do I have 2 bills for the same service?  

In many cases, services provided will have a hospital (technical) charge and a physician (care & expertise) charge.  As required by insurance companies, physician services are billed separately from the hospital charges (for lab work, room charges, medicines, etc?). For example, if you come in to have an X-ray done, there will be a hospital charge to perform the X-ray and then a separate charge for the radiologist to read the X-ray.

Why do I have 2 account numbers for one patient?  

We bill our Physician services separately from our Hospital charges. We use two different billing and payment processing systems and to ensure accurate posting of payments, we use different account numbers to distinguish between the two accounts. Your personal Medical Record number is the same throughout the health care delivery system.  It is only in the billing arena that different numbers are used to accommodate the two different billing systems.  

I required the services of a Fletcher Allen Anesthesiologist.  Why aren't those services represented on my regular Physician bill?  

Fletcher Allen has engaged a nationally recognized anesthesia billing company to process the anesthesia charges. In addition to our separate billing of our Hospital charges and our Physician charges, the services of the Fletcher Allen Anesthesiologists are billed separately by this company. The telephone number to reach anesthesia billing is 1-888-554-4119.   

Why wasn't my last payment reflected on this statement?  

When a payment clears the account in full, there is no subsequent billing of a zero balance statement. When a payment pays the account in part, the partial payment will be reflected on the next monthly statement. If a payment is received after the statement due date, it will not show on the next statement. Only those payments received before the due date are printed on the statement.   Please contact Customer Service with any questions you may have.   

Why am I sending my payments for Fletcher Allen to a Brattleboro address?  

Fletcher Allen uses the services of Chittenden Bank to accept and automatically post payments to our self-pay accounts. The Bank has instructed us to use the central office in Brattleboro for all self-pay payments.  

Why does my bill say "insurance rejected?"  

Your insurance has denied payment of the claim. You should have received an explanation from your insurance regarding why the service was not paid. If you did not receive an explanation from them or if you have questions about the explanation, contact the insurance company for the details.  Fletcher Allen receives the denial and posts it against your service.  If you need further assistance, please contact our Customer Service Department.  

My insurance company denied payment of my services stating "no referral."  What can I do?  

Contact your insurance to verify the denial reason and to ask if you are allowed to obtain a referral even after the service is rendered.  If you are not allowed to obtain a late referral, you will need to pay the full balance. If you are allowed to obtain a late referral, contact your physician and request a referral. After you receive the referral numbers, please contact Customer Service at Fletcher Allen and we will have the claim resubmitted to your insurance with the referral numbers on the claim.