PhysicianOne Urgent Care Billing services provided by:
Our dedicated team of coding and billing specialists is available to help you with your billing questions and provide assistance related to your bill and payments, from 9:00 am to 5:00 pm, Monday through Friday. To speak with a representative, please call: 203-885-0814.
Frequently Asked Questions:
Why am I being billed when I have insurance? Many insurance companies have amounts which the patient must pay. These are called deductible, co-pay, or co-insurance payments. If your insurance plan requires you to pay a deductible or co-insurance, the balance will be billed to you. If you have a question about why your insurance company did not pay part of a claim, please contact your health insurance company directly.
When will I get my bill? MD III Billing staff will collect payments from your insurance company (or companies) before sending you a final bill. The balance due after the payments have been applied will be billed to you via printed statement. The statements are generated within 48 hours of the final insurance payment being received and applied to your bill.
If my insurance doesn’t consider PhysicianOne Urgent Care as a preferred provider, will you bill my insurance? MD III bills all insurance carriers. If your insurer does not include PhysicianOne Urgent Care as a preferred provider, you may be billed for non-covered charges or be responsible for reduced benefits. Please contact your carrier to verify your coverage and/or benefits.
Why am I asked for my insurance card every time I visit? We have found that insurance information changes frequently. Asking for your insurance card at each visit is the surest way we know to make sure that your billing record is complete and accurate.
For Connecticut and Massachusetts patients:
Urgent Care Medical Associates LLC
P.O. Box 71454
Philadelphia, PA 19176-1454
For New York patients:
Urgent Care Medical of New York LLC
P.O. Box 71455
Philadelphia, PA 19176-1455
Helpful billing terms:
Explanation of Benefits (EOB): A statement an insured member receives from an insurance company that lists the services provided at PhysicianOne Urgent Care, the amount billed, any insurance payments, and patient responsibility.
Co-pay: A specified dollar amount that is determined by a patient’s insurance company, and paid out-of-pocket toward a specified service at the time of service.
Deductible: A specified financial amount agreed upon by the insured member and the insurance company that an insured member must pay toward medical services before the insurance company will make any payments. Common deductibles can range anywhere from $2,500.00 to $5,000.00 per individual and can be as much as double for a family.
Guarantor: Someone, who may or may not be the patient, who either accepts or is legally responsible for the payment of bills for medical services. The guarantor is often a parent or guardian of a minor child.
Patient Responsibility / Financial Responsibility: The amount of a medical bill that a patient is required to pay.
Insured Member / Subscriber / Beneficiary: Someone who has medical coverage through a health insurance company.
In-Network: When a doctor, hospital, or other healthcare provider participates in an insurance plan’s network, the provider agrees to accept your insurance payment for covered services as payment in full (minus your deductibles, co-pays, and co-insurance amounts).
PhysicanOne Urgent Care participates with many plans.
Contact your insurer for specifics about your plan.
Out-of-Network: When a doctor, hospital, or other healthcare provider is not part of an insurance plan’s network, it is considered a Non-Participating or Out-of-Network Provider. If a patient receives medical services from an Out-of-Network Provider, the patient may be responsible for higher costs or the payment in full (for all services rendered).
Statement Balance: The amount that a doctor, hospital, or other healthcare provider charges a patient after the patient’s insurance company, or Medicare has paid its approved amount.
Co-insurance: The portion of the balance for covered medical expenses that an insured member must pay after payment of the deductible. Examples are 10%, 20% co-insurance. The co-insurance is often collected at the time of service.
Pre-authorization: The process of obtaining permission to perform a service from the insurance carrier before the service is performed. Pre-authorizations are often needed for CT scans and MRIs in the Urgent Care setting.
Always contact your insurance carrier with specific questions regarding your plan and coverage.