Insurance and Billing Plain Language Summary

We're here to help.

We understand that working with insurance companies and understanding your bill can sometimes be confusing. For questions, please call our Account Services Representatives at 800-450-6101 or 320-759-4242, Monday-Friday, 8am-4:30pm. Hearing-impaired patients may call 877-746-4674.

Alomere Health exists to provide quality health care services, to meet the needs of our customers and to demonstrate our commitment to excellence.

Notice of Privacy Practices

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

Billing Overview

For services rendered at Alomere Health, Alexandria Clinic, Lakes E.N.T and Heartland Orthopedic Specialists, patients receive 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.

Insurance

Please present your health insurance information and identification cards upon admission. 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.

Please check with your insurance carrier by calling the number on the back of your card to verify if services provided would be processed "in network."

Uninsured Patients

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 are ready and willing to help you complete applications for assistance. 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.

Zero-Interest Patient Financing

As a benefit to our patients, the ClearBalance® program is a patient-friendly payment option to help you pay your cost of service with Alomere Health. The program is a zero-interest revolving credit account* with flexible payment terms. Use the ClearBalance program to manage your out-of-pocket expenses, including deductibles and insurance co-payments, for care at any Alomere Health facility. Download our brochure or call us for more information: 320.759.4242.

ClearBalance offers you peace-of-mind.

  • Zero-interest credit account for your services at Alomere Health
  • No credit check
  • Combine all of your family’s medical bills at Alomere Health into one monthly statement and one manageable monthly payment
  • Convenience to manage and view your account online at myclearbalance.com
*Revolving credit accounts are offered by MetaBank®, N.A., member FDIC. ClearBalance is a registered service mark of CSI Financial Services, LLC, which provides certain account servicing functions for the bank.


Applying for Financial Assistance

To apply for financial assistance, patients must submit a signed, completed application with supporting documents by mail to: Account Services Representatives, Alomere Health, 111 E 17th Avenue, Alexandria, MN 56308. Applications may also be presented in person at one of our conveniently located offices at Alexandria Clinic, Alomere Health or Heartland Orthopedic Specialists.

Alomere Health Financial Assistance Application 

In addition to assisting our patients with financial assistance applications, some of the services provided by our Account Services Representatives include:

  • Estimates of costs prior to service
  • Pre-service payment options
  • Financial counseling
  • Questions or concerns regarding the billing
  • Assistance in making a payment or setting up a payment plan. For patient convenience, we accept Mastercard, Visa, Discover, and American Express.

Services Eligible for Financial Assistance

Services eligible for financial assistance include services deemed medically necessary by Alomere Health. 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. Uninsured patients will receive an uninsured discount on medically necessary services.

Collection Accounts

If your account is past due and has been sent to a collection agency

• In certain instances, we will not be able to honor your requests for appointments with Alexandria Clinic, Lakes E.N.T. or Heartland Orthopedic Specialists until the past due balances have been paid in full or resolved through our Community Uncompensated Care program.

• The collection agency may request authorization for legal handling.

• A claim maybe submitted to the MN Revenue Recapture program where your future state income and property tax refunds, lottery winnings and other sources may be used to offset your debt as allowed under the Revenue Recapture Act MN Statute 270A. The MN Department of Revenue will apply a $15 fee each time a refund is sent to us and will  continue each year until your balance is paid in full.  

Price Transparency

Beginning January 1, 2021 the U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services are requiring hospitals and health systems to post a comprehensive machine Readable file with all the 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: Price_Transparency_Final.csv.

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

For non-MyChart users, or guests of our facility: Click Here

  • 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

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.