Have questions? Just ask.

Medical privacy is important to us. Since billing may involve sensitive information, please read Alomere Health’s HIPAA & Minnesota Law Notice of Privacy Practices.

Fees for services rendered at Alomere Health, Alexandria Clinic, Lakes E.N.T., and Heartland Orthopedic Specialists will be compiled into one convenient monthly statement. Fees for services rendered by anesthesiologists, oncologists, and other physicians will be sent directly from their billing offices.

Full payment is due and payable upon receipt of the first statement. Payment plans may be approved by an Account Services Representative for patients unable to pay in one installment. Self-pay balances remaining due after 30 days are subject to a finance charge of 6% per annum.

Alomere Health is not required to accept patient-initiated payment arrangements and may refer accounts to a collection agency if patient is unwilling to make acceptable payment arrangements or has defaulted on an established payment plan.

Please present your health insurance information and identification cards upon admission for care. Co-pays are payable on the day of service. Pre-payment is required for services that are deemed to be not medically necessary by insurance plans, and for uninsured patients.

Before receiving services, please check with your insurance carrier by calling the number on the back of your insurance card to verify whether services provided would be processed “in network” or “out of network”.

If you need help paying your bills, please contact our Account Services team. We can help you with the following services:

• Estimates of costs prior to service
• Pre-service payment options
• Financial counseling
• Questions or concerns regarding the billing
• Help making a payment or setting up a payment plan. (For patient convenience, we accept Mastercard, Visa, Discover, and American Express.)
• Help applying for financial assistance
• And more

As part of our commitment to serving our community, Alomere Health’s Account Services Representatives are available Monday through Friday, 8:00 am to 4:30 pm to help you understand options that may be available to you.

You can reach our team by calling 320-759-4242 or 800-450-6101 OR stop by the Business Office located at 1500 Irving Street.

As part of our commitment to serving our community, Alomere Health offers a financial assistance program. Patients may apply for our program at any time.

This program provides discounted care based on family size and household income. Patients who are uninsured or underinsured and have a household income between 100% and 244% of the Federal Poverty Guidelines (FPG) or below may qualify for our financial assistance program.

• Plain Language Summary: Community Uncompensated Care Policy – English
• Plain Language Summary: Community Uncompensated Care Policy – Spanish
• Alomere Health’s Community Uncompensated Care Policy – English

In order to apply for financial assistance with Alomere Health, you must complete, sign, and submit the application form, including all supporting documents.

• Financial Assistance Application – English
• Financial Assistance Application – Spanish

You can drop off or mail your application and supporting documents here:

Account Services Representatives

Alomere Health Plaza
1500 Irving Street, Alexandria MN 56308

Account Services representatives are available Monday through Friday, 8:00 am to 4:30 pm to answer your questions and help you complete an application. You can reach our team by calling 320-759-4242 or 800-450-6101 OR stop by the Business Office at 1500 Irving Street, Alexandria.

Uninsured patients will receive an uninsured discount for medically necessary services. Payments are due upon receipt unless other arrangements have been made.

Those in need of care for which they are unable to pay may partner with our Account Services Representatives. Our team of professionals is ready and willing to help you understand options that may be available to you. Please let us know of your concerns as soon as possible so that we can explain the options available to help with your specific needs. (For more information, see the Financial Counseling tab)

Looking for coverage?

Fortuna Health: Alomere is proud to offer Fortuna Health at no cost to our patients. Fortuna is a digital tool that allows you to check your eligibility and enroll in no or low-cost government health insurance programs like Medical Assistance or MinnesotaCare through MNsure (the Minnesota state marketplace). 1 in 4 Minnesotans qualify for these programs. Click here to screen your eligibility in under 60 seconds. You can also access Fortuna’s certified MNsure assisters for free help via chat, email, or phone.

MnSure Enrollment: On the MnSure marketplace, you can find, compare, choose, and get quality heathcare coverage including commercial health insurance plans and low-cost or free plans through the government. If you are eligible for a government program, such as Medical Assistance or Minnesota Care, you can enroll through MnSure year-round. Account Services representatives can help you decide which application process is best for your situation.

Click the link to learn more or to start an application: Apply and Enroll / MNsure

West Central Minnesota Community Action has certified MnSure navigators who are able to assist with applying for healthcare coverage. You can reach them at 320-304-3458 or by email amberh@wcmca.org

Click the link to learn more: Health Archives – West Central Minnesota Communities Action, Inc. (wcmca.org)

Zero-Interest Patient Financing: ClearBalance®

As a benefit to our patients, we offer the ClearBalance program to help you pay for the cost of services with Alomere Health. You can use ClearBalance to manage your out-of-pocket expenses, including deductibles and insurance co-payments, as well as for care at any Alomere Health facility. And you can combine all of your family’s medical bills at Alomere Health into one monthly statement and one manageable monthly payment.

ClearBalance offers:

• A zero-interest credit account for your services at Alomere Health
• Flexible payment terms
• No credit check
• Convenient online account management at myclearbalance.com

To learn more about ClearBalance, click here to download our brochure or call us at 320-759-4242.

*Note: Revolving credit accounts are offered by Pathward™, N.A., Member FDIC. ClearBalance is a registered service mark of CSI Financial Services, LLC, which provides certain account servicing functions for the bank.

Purpose

It is the goal of this policy to provide clear and consistent guidelines for conducting billing and collections functions in a manner that promotes compliance, patient satisfaction, and efficiency. Through the use of billing statements, written correspondence, and phone calls. Alomere Health will make diligent efforts to inform patients of their financial responsibilities and available financial assistance options, as well as follow up with patients regarding outstanding accounts. Additionally, this policy requires Alomere Health to make reasonable efforts to determine a patient’s eligibility for financial assistance under Alomere Health’s financial assistance policy before engaging in extraordinary collection actions to obtain payment. 

Scope

After our patients have received services, it is the policy of Alomere Health to bill patients and applicable payers accurately and in a timely manner. During the billing and collections process, staff will provide quality customer service and timely follow up, and all outstanding accounts will be handled in accordance with the Attorney General requirements. Alomere Health and all of its services comply with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. DCH does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. 

Procedures

Billing Practices

1. Insurance Billing
   1. For all insured patients, Alomere Health will bill applicable third-party payers (as based on information provided by or verified by the patient) in a timely manner.
   2. If a claim is denied (or is not processed) by a payer due to an error on our behalf, Alomere Health will not bill the patient for any amount in excess of what the patient would have owed had the payer paid the claim.
   3. If a claim is denied (or is not processed) by a payer due to factors outside of our organization’s control, staff will follow up with the payer and patient as appropriate to facilitate resolution of the claim. If resolution does not occur after prudent follow-up efforts, Alomere Health will follow guidelines outlined in their payer contracts, may bill the patient, or take other actions consistent with current regulations and industry standards.
2. Patient Billing

All uninsured patients will be billed directly and timely, they will receive a statement as part of the organization’s billing process. Uninsured self-pay patient will receive an uninsured discount prior to statement being sent. The Alomere Health Uninsured Discount Program is available only to patients who annual gross household income is verified as less than $125,000.00, and who do not have insurance, third party payer resources, or government-supported programs to cover Alomere Health charges. Medically unnecessary procedures are not subject to this discount. See uninsured policy.

1. 1. For insured patients, after claims have been processed by third-party payers, Alomere Health will bill patients in a timely fashion for their respective liability amounts as determined by their insurance benefits.
   2. All patients may request an itemized statement for their accounts at any time.
   3. If a patient disputes his or her account and request documentation regarding the bill, staff members will refer account to their immediate supervisor to be handled.
   4. Alomere Health may approve payment plan arrangements for patients who indicate they may have difficulty paying their balance in a single installment.
      1. Patient Financial Services Supervisors and Directors have the authority to make exceptions to this policy on a case-by-case basis for special circumstances.
      2. Alomere Health is not required to accept patient–initiated payment arrangements and may refer accounts to a collection agency as outlines below if patient in unwilling to make acceptable payment arrangements or has defaulted on an established payment plan. 

Collection Practices

1. In compliance with relevant state and federals law, including the Attorney General, and in accordance with this Billing and Collection Policy, Alomere Health may engage in collection activities – including extraordinary collection actions – to collect outstanding patient balances. 
   1. General collection activities may include:
      1. First statement sent. Payments are due according to parameters defined on statement.
         1. If no payment or communication is received from patient for balance greater than $200.00 within 30 -45 days after first statement, a Financial Advocate will contact the patient. The Financial Advocate will ask patient to contact our office and offer financial counseling. 
      2. Approximately 30-45 days after first statement: Phone call and/or letter
      3. Approximately 45-60 days past first statement: Phone call  and/or letter
      4. Approximately 60-75 Days after first statement: Phone call and/or letter
      5. Approximately 75-90 days after first statement: Phone call and/or final letter
      6. Approximately 90 days after first statement: Final Notice letter.

If no payment is received 30 days from the final notice or payment is received but not in conjunction with an agreed upon payment plan, the account will be forwarded to an outside collection agency.

1. 1. Patient balances may be referred to a third party for collection at the discretion of Alomere Health. Alomere Health will maintain ownership of debt referred to debt collection agencies, and patient accounts will be referred to collection only with the following caveats:
      1. There is a reasonable basis to believe the patient owes the debt.
      2. All third-party payers have been properly billed, and the remaining debt is the financial responsibility of the patient. Alomere Health shall not bill a patient for any amount that an insurance company is obligated to pay.
      3. Alomere Health will not refer accounts for collection while a claim on the account is still pending payer payment. 
      4. Alomere Health will not refer accounts for collection where the claim was denied due to a Alomere Health error. However, Alomere Health may still refer the patient liability portion of such claims for collection if unpaid.
      5. Alomere Health will not refer accounts for collection where the patient has initially applied for financial assistance and Alomere Health has not yet notified the patient of its determination (provided patient has complied with the timeline and information requests delineated during the application process).
2. Reasonable Efforts and Extraordinary Collection Actions
   1. Before engaging in extraordinary to obtain payment for care, Alomere Health must make certain reasonable efforts to determine whether an individual is eligible for financial assistance under our financial assistance policy:
      1. Extraordinary collection actions may begin only when 120 days have passed since the first post-discharge statement was provided.
      2. However, at least 30 days before initiating extraordinary collection efforts, Alomere Health shall do the following:
         1. Provide the individual with a written notice that indicates the availability of financial assistance, lists potential collection actions that may be taken to obtain payment for care, and gives a deadline.
         2. Provide a plain language summary of the financial assistance policy/application.
         3. Attempt to notify the individual orally about the financial assistance policy and how he or she may get assistance with the application process. 
   2. Alomere Health Director of Revenue Cycle and Chief Financial Officer are ultimately responsible for determining whether Alomere Health and its business partners have made reasonable efforts to determine whether an individual is eligible for financial assistance. This body and/or the Hospital Governing Board also has final authority for deciding whether the organization may proceed with any of the extraordinary collection actions outlined in this policy.
3. Financial Assistance
   1. All billed patients will have the opportunity to contact Alomere Health regarding financial assistance for their accounts, payment plan options, and other applicable programs. Reference the financial assistance policy for guidelines and procedures
   2. Individuals with questions regarding Alomere Health’s financial assistance policy may contact the financial counseling office by phone at 320-759-4242 or 1-800-450-6101.
4. Customer Service
   1. During the billing and collection process, Alomere Health will provide quality customer service by implementing the following guidelines:
      1. Alomere Health will enforce a zero tolerance standard for abusive, harassing, offensive, deceptive, or misleading language or conduct by its employees.
      2. Alomere Health will maintain a streamlined process for patient questions and/or disputes, which include toll-free phone number patients, may call and a prominent business office address to which they may write. This information will remain listed on all patient bills and collections statements sent. 
      3. After receiving a communication from a patient (by phone or writing) Alomere Health staff will return phone calls to patients as promptly as possible (but no more than one business day after the call was received) and will respond to written correspondence within 10 days.
      4. Alomere Health will maintain a log of patient complaints that will be available for audit.

Price Transparency

The U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services require hospitals and health systems to post a comprehensive machine-readable file that shows the pricing of all items and services. The Standard Charges should include, the Gross Charge, the Discounted Cash Price, Payer-Specific Negotiated Charges, and the De-Identified Minimum and Maximum Negotiated Charges.

In compliance with the Centers for Medicare & Medicaid Services (CMS) requirement for Hospital Price Transparency, we provide this Excel document here: Standard Charges_csv. or Standard Charges_json.

In compliance with the Centers for Medicare & Medicaid Services (CMS) requirement to display shoppable services in a consumer-friendly format, we provide the links below. This includes the 70 shoppable service items that CMS requires, along with an additional 230 service items, for a total of 300. If you are a MyChart user, this information can be accessed within MyChart under the Get an Estimate tool, once you have logged into the system.

• For MyChart users: Click here.
• For non-MyChart users, or guests of our facility: Click here.

Please note:

• Hospital charges are the amount a hospital bills an insurer for a service. For most patients, hospitals are reimbursed at a level well below charges. Patients covered by commercial insurance products have negotiated rates with hospitals. Patients covered by Medicare or Medicaid programs have hospital reimbursement rates determined by federal and state governments.
• Hospital charges may include bundled procedures, personnel, services, and supplies. An example would be room rates that include the space, equipment, nursing personnel, and supplies.
• When a patient has the opportunity to shop for medical services, he or she should contact his or her own insurance carrier to understand which costs will be covered and which will be the patients responsibility.
• Patients should contact the hospital directly for any further details.

“Alomere Health and all of its services comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Alomere Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.”

In Compliance with the Centers for Medicare & Medicaid Services (CMS) requirement, we provide this Excel Document, listing the top 25 codes over $25.00 for the Primary Care Clinics (Family Medicine, General Internal Medicine, Gynecology or General Pediatrics).

No Surprises Act

Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.

• Model_of_Disclosure_Notice_Suprise_Medical_Billing.pdf
• Right_to_Receive_a_Good_Faith_Estimate_of_Expected_Charges_NoticeForm.pdf

Machine Readable Files

To continue to comply with the Transparency in Coverage Act, Blue Cross and Alomere Health are providing the following link to the Blue Cross website that houses Machine Readable Files as required by the July 1, 2022 compliance date. The webpage contains:

• A link to our MRF pricing file(s)
• Contents explaining the MRF mandate
• Links to related government documentation on the MRF mandate

Blue Cross published Machine Readable File information: bluecrossmn.com/MRF

MHA Hospital Price Check

To learn more about hospital pricing, visit the Minnesota Hospital Association’s Hospital Price Check Page. You can search for both inpatient and outpatient procedures.