/depts/,/depts/uwmf/,/depts/uwmf/patient-business-services/,

/depts/uwmf/patient-business-services/

201409268

page

100

UWMF,

Patient Services,Business,

Departments & Programs,UW Medical Foundation

Patient Business Services

Patient Business Services - Departments & Programs, UW Medical Foundation

Patient Business Services and Patient Financial Services work together to maintain UW Medical Foundation's billing processes. Divided into specialized teams, these departments work to make a patient's billing process as simple as possible.


FAQ

Can patients get on a payment plan for large bills?

Yes. Patients may contact Patient Business Services for more information.

Can patients pay their bills online?

Yes. Patients can visit the Bill Pay section of uwhealth.org to easily submit their payments online by using their credit card.

Do we provide care for patients without insurance?

Yes. UW Health does provide care to patients without insurance. The UW Health Community Care program is designed to provide care to individuals who are unable to pay for medical services. Individuals may call UW Medical Foundation at (608) 829-5254 or UW Hospital and Clinics at (608) 262-2221 for more information.

How do I obtain cost or fee information on medical services?

Price estimates can be obtained from UWMF's Priceline at (608) 829-5637.

How do I prevent duplicate coverages, retroadjudication, claim rejections and upset patients?

Following these comments will help prevent duplicate coverages, retroadjudication, claim rejections and upset patients.

Termination dates - Term dates for Unity are normally the first day of the month, but not always. Term dates for PPIC and GHC are normally the last day of the month, but not always. Dates must be verified before loading into EPIC.

Newborns - The effective date of coverage for newborns is the baby’s birth date. Newborns are never effective before their date of birth.

Loading coverage - If you’ve verified the coverage and are preparing to load it, check to see if the coverage already exists on another family member. If it does, use the existing coverage instead of creating a new coverage.

Punctuation - When adding Managed Care coverages, do not use punctuation. There should be no dashes or dots of any kind in the member numbers.

HMO/MA - Remember to use the six-digit member number for GHC coverages even if it’s a GHC/MA coverage. This applies to GHC of Eau Claire, as well. Both carriers use their own six-digit member number and not the MA number. Unity uses the normal eleven-digit member numbers for Unity/MA patients, not the MA number.

Member number - Please remember to add the person code for PPIC and Unity members. If the member number is not correct, eligibility will ignore the coverage that was loaded with an incorrect member number and add a duplicate coverage. Wrong member numbers will not only cause duplicate coverages and retro issues, but claim rejections as well.

 If Unity system reads  Then enter into Epic
 00 (self)  01 (self)
 01 (usually spouse, but not always)  02
 02-99 (dependent)  16 (sponsored dependent)
 If PPIC (Amysis) system reads  Then enter into Epic
 01 (self)  01 (self)
 02 (usually spouse, but not always)  02
 03-99 (dependent)  16 (sponsored dependent)

 

We had to choose “generic” dependent codes for this field because most carriers don’t give us what the dependents true relationship to the subscriber is (Spouse, Foster Child, Grandchild, Natural Child, etc.), only that they are a dependent. It is very important to use the correct code in this field, because if the information is not correct, eligibility may ignore the manually loaded coverage and load another coverage.

How much are hospital and ER copays for PPIC?

Please contact PPIC directly to answer this question. You may do so by visiting their website at https://www.pplusic.com/contact.

What do I do if a patient presents and states that his or her Unity, PPIC or GHC coverage has terminated, but our system is showing it has not terminated?

If you have online access to Unity, PPIC or GHC systems, check the appropriate system. If the coverage is showing as termed on the payor’s system, term the patient’s coverage in Epic. If the coverage is showing as effective on the payor’s system, leave the patient’s coverage as is in Epic. Wait for the eligibility feed to provide the correct information. While this seems incorrect, it actually is better for the patient because if the coverage is termed in Epic and the next eligibility feed comes through and shows the coverage as active, the system will automatically turn the coverage back on and retroadjudicate charges posted during this “on/off” timeframe. If you do not have online access to the payor’s system, contact the central registration hub at (608) 287-2725 or (888) 863-2725. Registration hub staff will follow the above procedure.

What do I do if a patient presents and states that Unity, PPIC, or GHC coverage is effective, but our system is not showing it?

If you have online access to Unity, PPIC or GHC systems, check the appropriate system. If the coverage is showing as effective on the payor’s system, add the coverage and effective date in Epic. If the coverage is not showing on the payor’s system, do not enter it into Epic. Wait for the eligibility feed to provide the correct information. Again, while this seems incorrect, it actually is better for the patient because it creates less back-end work and errors. If you do not have online access to the payor’s system, contact the central registration hub at (608) 287-2725 or (888) 863-2725. Registration hub staff will follow the above procedure. 

Resources

Departmental Structure

Fee Requests

Fee Schedule Lookup (UWMF)

Request to Establish or Revise Procedure Fee

General Registration Forms

Health Link Registration Forms

Health Link Potential Duplicate Patient Notification (UWMF)

Insurance Information

Policies

Patient Business Services Policies

Related

Billing

Coding and Charge Capture

Patient Accounts

Patient Business Services (UWHC)

Registration and Technical Services

Provider Enrollment