Insurance and Billing

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Lutheran Medical Group Billing Office
(260) 458-3300 (260) 458-3300
Monday–Friday | 8:30 a.m.–5 p.m.

Mailed payments should be sent to:
Lutheran Medical Group, LLC
P.O. Box 4852
Belfast, ME 04915-4853

For credit and debit card payments, call (877) 455-4778 (877) 455-4778 .

Insurance and Payments
To make sure there are no surprises after you have an appointment at LMG, it is a good idea to contact your insurance company to make sure the services you will be receiving are covered under your plan. By calling ahead, you can ensure you are not held responsible for large, out-of-pocket expenses and that you receive the maximum benefits your plan allows. Be aware that some insurance companies pay a fixed amount toward a certain procedure and others pay a percentage of the overall cost of the procedure.

The LMG billing staff will submit your claim directly to your insurance company, but remember that ultimately, no matter what type of insurance you carry, you are responsible for payment of services rendered at LMG. This includes:

  • Co-payment at the time of service. VISA, MasterCard (credit and debit), checks and cash are accepted.
  • Deductibles and co-insurance payments.
  • Any remaining balance after the insurance payment.

Patients will receive a statement after LMG has received payment or a response from the insurance company. This statement is the first notification a balance is due, and full payment is due upon receipt.

Secondary Insurance
LMG will file secondary insurance claims as a courtesy to patients if the insurance information was given at the time of service. If the balance is not paid within 30 days from the date of secondary insurance filing, LMG will bill the patient the balance, unless otherwise restricted. Medicaid patients will receive a statement unless they are eligible for benefits, do not have a deductible or have other insurance.

Medicare Assignment Program
LMG participates in the Medicare Assignment program. Patients in this program are responsible for 20 percent of the Medicare-allowable portion of the cost of their services, with the exception of laboratory services, which are covered 100 percent. Medicare patients are also responsible for deductibles and noncovered services. Although LMG will bill Medicare for your charges and also file claims with secondary insurance providers, payment for noncovered fees is expected at the time of service.

Medicare and Medicaid Noncovered Services
Medicare and Medicaid only pay for tests and procedures considered medically necessary. Prior to services being rendered, LMG is required to identify Medicare and Medicaid noncovered services and issue an Advanced Beneficiary Notice of Non-Coverage form (Medicare) and/or a Waiver of Liability form (Medicaid) to notify patients of their financial responsibility.

  • The patient may sign the form, have the test or procedure performed and be billed for it.
  • The patient may refuse to sign the form, have the test or procedure performed and be billed for it. If the patient refuses to sign the form, a witness must also sign the form to indicate that the form was offered but refused and permission was granted for tests or procedures to be performed.

Medicare and Medicaid patients will not receive a statement until after payment or a response has been received from Medicare and/or Medicaid.

Denial of Claims
LMG will not become involved in disputes between patients and their insurance company regarding deductibles, co-payments, noncovered charges, secondary insurances and usual and customary charges, other than to supply factual information as necessary. Patients are responsible for timely payment of their account.

Credit Arrangements
Reasonable attempts will be made to communicate with patients regarding their accounts and to work with them to reach agreeable resolutions within federal guidelines and company policies. If full payment of the outstanding balance presents a severe financial hardship, patients should call the LMG business office.

Collections
Accounts must be resolved no later than 60 days from the date of service. Resolution of an account means:

  • The account is paid in full.
  • Acceptable payment arrangements have been made.

LMG reserves the right to pursue other legal means of collection. Patients/guardians are responsible for all charges incurred in an effort to collect past-due balances, such as attorney and collection fees.

Worker's Compensation
Worker's compensation claims require patients to bring written authorization from their employer. Failure to provide employer authorization will result in the need for full payment at the time of service.

Auto Insurance Liability
In the event of services rendered as the result of an automobile accident, LMG will file the claim with the patient's auto insurance. If this information is not obtained at the time of service, charges will be filed with the patient's medical insurance. If the claim is denied, the charges become the patient's responsibility. LMG will not become involved in disputes between patients and their insurance carrier.

Medical Records
Indiana law permits a fee to be assessed for the copying of medical records. The fee must be paid in full and a consent form signed by the patient or legal guardian prior to the release of records.

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LUTHERAN HEALTH NETWORK
BLUFFTON REGIONAL MEDICAL CENTER | DUKES MEMORIAL HOSPITAL | DUPONT HOSPITAL* | KOSCIUSKO COMMUNITY HOSPITAL*
LUTHERAN HEALTH PHYSICIANS | LUTHERAN HOSPITAL* | THE ORTHOPEDIC HOSPITAL* | REDIMED | REHABILITATION HOSPITAL*
ST. JOSEPH HOSPITAL*

*A physician owned hospital.

If you are experiencing a medical emergency, call 911.
Patients are seen in order of severity, therefore, your spot may not be guaranteed. In case of a life-threatening emergency, call 911.
Patient results may vary. Consult your physician about the benefits and risks of any surgical procedure or treatment.