Billing & Payment Information

Payment Due at the Time of Service/Registration

Franklin County Medical Center asks for payment upfront for your share of the bill, as most businesses do. This might include co-payments, co-insurance, deductibles, and services not covered by your insurance program.
For your convenience, we accept cash, check, debit and credit cards, money orders, as well as American Express, Discover, MasterCard, and Visa credit cards.

Health Insurance

FCMC accepts most insurance plans, and as a courtesy to our patients, we will file a claim directly with your insurance company. After filing the claim, the Business Office will follow up with the claim payment status. If no is received payment from a patient’s insurance provider within an appropriate time, we will bill the patient for services. If there are any questions or concerns regarding the insurance payments or the statements received in the mail we encourage the patient to contact the Business Office.

What if I forget to bring my insurance information to the appointment?

You will be registered as “private pay” during registration, which means you are responsible for paying the entire bill. We require patients to present Insurance Cards at every visit.

Private Pay

Patients who do not carry health insurance are considered private pay accounts. For private pay accounts payment is due at the time of service. If we do not have the exact amount due at the time of service, we will require a deposit. The deposit may vary, depending on the particular type of service.

Emergency Room Billing

A nurse will assess ALL Emergency Room (ER) patients. The ER Nurse will establish the order in which patients will be seen based on a professional assessment of the patient’s symptoms and vital signs. Vital signs taken include blood pressure, temperature, respiration, and oxygen levels (when necessary). All patients are billed for this professional service. Wait times vary depending on the number of patients and the severity of each patient’s medical needs. Co-payment is due at the time ER services are provided.

Auto/Workers’ Comp Insurance

Please tell us if your visit is a result of an auto accident or work injury the day you come to FCMC. We will follow up with the appropriate party to acquire a claim number. On these types of visits, your health insurance will never be billed primary. To request payment from your health insurance carrier, we must provide a letter from the primary payer that all funds have been exhausted or denied.

Patient Price Information List

Franklin County Medical Center determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. For more information, please refer to the Patient Price Information List.

No Surprise Act / Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call (800) 985-3059.

YOUR RIGHTS & PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed:

You may contact the Idaho Department of Insurance by visiting the department’s website at doi.idaho.gov/nosurprises or calling the Consumer Affairs section at 1-208-334-4319 or toll-free in Idaho at 1-800-721-3272.

Visit doi.idaho.gov/nosurprises for more information about your rights under this law.

Patient Portal

We have moved to a new all-in-one patient portal and payment system for both FCMC and Willow Valley Medical Clinic. During the transition please choose one of the options below that best describes your visit (before or after October 30, 2018).