Billing Questions
What is this bill for?
QMACs bills for physicians and physician groups that charge for services
according to industry standard fee schedules; these fee schedules are based
upon Current Procedural Terminology (CPT) codes and International Catalog of
Diseases, edition 9 (ICD-9) codes.
Why is my bill this amount?
QMACs bills for physicians and physician groups that charge for services according to industry standard fee schedules.
These fee schedules are based upon Current Procedural Terminology (CPT) codes and International Catalog of Diseases, edition 9 (ICD-9) codes.
QMACs coding department receives the physician's documentation of the patient's visit and assigns the appropriate CPT and ICD-9 codes in
adherence to current government regulations.
Why hasn't my insurance paid this claim?
We may not have the correct information, found on your current insurance card,
including:
- Name of insurance company
- Address of insurance company
- Phone number of insurance company
- Subscriber name
- Subscriber/patient insurance ID
- Insurance Group number
- Subscriber/patient Social Security number
- Relationship of patient to subscriber
Additionally, your insurance company may not have paid in a timely manner.
We are billing you as the responsible party. Please call your insurance company to
determine whether a problem exists concerning your account.
Contact us of any information we might add to help process your claim. If your
insurance company agrees to pay your claim but is unable to locate it in their
system, please let us know the name of the person you spoke with and their fax
number. We will send the necessary form to that individual.
Note:
We can fax claims only to the attention of the individual who has agreed to
process the claim. Your insurance may not have been in effect on the date of
service or it may not cover one or more procedures provided. Please call your
insurance company to determine if a problem exists concerning your account.
Contact us with any information we might add to help process your claim.
Why did I get this bill when I have already paid for the visit?
QMACs may have received your payment after the billing statements were mailed. You
may have made a payment to the hospital, facility, other services, supplies, or
equipment. This bill is for the physician responsible for your visit.
May I pay off my balance with a payment plan?
Yes, but you must let us know that you would like to establish a payment plan.
We will set up a monthly payment schedule. Should a lapse in payments occur
without prior notification to us, we may send your account to a collection agency.
What is the status of my account?
A QMACS customer support representative will explain and or fax a copy of your
account's history reflecting all credits and debits to your account(s) upon request.
What should I do if I don't think I received the services on the statement?
Contact a QMACs customer support representative about your concerns. Our customer
support representative will investigate and advise you of the findings and let
you know what remedial action, if any, is taken.
Why do I have a balance if my insurance has paid?
This may be the amount that your insurance company determined that applies to your
deductible, which is your responsibility. Your insurance may not cover a service(s)
you received, making the charge for that service your responsibility. The physician
may not be listed in your plan or network. Your insurance company may have paid
according to your out-of-network physician benefits.
Why isn't the physician in the same plan as the facility?
Physicians/physician groups negotiate contracts with insurance carriers as do
hospitals, labs, surgery centers, etc. It is possible for a physician to practice
in a facility that has different contracts than the physician. In non-emergency
situations, you have the option to choose a physician that is listed in your
insurance plan, or at a higher cost to you, you may choose a physician out of your
plan.
Your physician will give you options concerning the facilities in which he/she may
perform services, and you can make a determination on whether you prefer to use an
in-network or out-of-network facility.
In emergency situations, you usually choose the facility that is under your
plan. If the emergency physician does not have a contract with your insurance
carrier, they may have paid the physician fee as out-of-network. You should
request your insurance company to reprocess your claim according to your emergency
or in network benefits.
Why am I getting bills from a collection agency?
QMACS may have sent your account to a collection agency because the billing
statement was returned to us with no forwarding address. You should make
payment arrangements with the collection agency or us within the time mentioned
on your notice or the collection agency may report your account to the Credit
Bureaus as unpaid.
QMACS might have sent your account to a collection agency because you had not
responded to our statements or pre-collection notice. You should make payment
arrangements with the collection agency or us within the time mentioned on your
notice, or the collection agency may report your account to the Credit Bureaus as
unpaid.