Billing FAQ

Out-of-network means a doctor or facility does not have a contract with your health insurance plan. Patients may end up paying more for their services when they are seen outside of their network.

If your visit needs to be billed as accident coverage, such as auto insurance, homeowners’ insurance, or work comp insurance, you will need to provide the insurance information at the time of your appointment. If this information is not received, Essentia will bill the charges to your personal insurance. If you do not have the insurance information at the time of your visit, a form will be mailed to you to complete. If Essentia does not receive the required paperwork, you will be responsible for the balance.

Insurance coverage can change frequently. Your insurance card provides essential coverage information needed to get your services processed in a timely manner.

If your insurance information has changed, provide your new insurance information at your next appointment. You can also do this while using the eCheck-in feature in MyChart.

At Essentia Health, we will send a claim to your insurance company. This will list the services you received at your appointment. HIPAA regulations state that healthcare facilities must supply the covered person’s complete information to the insurance company. Without this information, insurance companies can deny claims or delay insurance payments.

Charges not paid by the insurance company become the patient’s responsibility. A statement will be sent to the patient (or guarantor) requesting payment for the remaining balance.

Your insurance company will send you an explanation of benefits (EOB). This will show how insurance processed your medical claim and any amount you will owe. Your EOB will state "This is Not a Bill," and any insurance payments will be reflected on your monthly Essentia Health billing statement.

All Medicare providers are mandated by federal law to complete the Medicare Secondary Payer (MSP) Questionnaire. This verifies whether Medicare should be billed first (primary) or if there is another payer, such as an Employer Group Health Plan, that is primary.

You may receive a bill if your insurance company leaves a balance remaining after it processes your claim. Essentia Health bills insurance claims daily. Insurance companies usually process claims within 30-60 days. This time frame may be longer if the insurance company requests more information or denies the claim.

Essentia Health will send a patient billing statement to you after the insurance company processes a claim and a patient balance is due. The length of this process depends on how long it takes your insurance company to send a response to Essentia Health.

Review an example statement with explanations on the Get to Know Your Statement document.

A guarantor is the person assigned as responsible for the bill. The guarantor account number is helpful, but not required, to locate your account. You can find this number on the top right-hand section of your statement highlighted in yellow.

Essentia Health has many guarantor types for the different types of services a patient may receive, including those related to work injuries or motor vehicle incidents. Each account is assigned its own guarantor number for tracking purposes.

The Health Insurance Portability and Accountability Act (HIPAA) states we can only discuss account or billing information with the patient and/or guarantor of the account.

Some services, such as radiology, labs, and surgeries, have many billing components. These include a professional component, which covers the provider’s services, and a technical component, which covers the service itself.

An example would be radiology charges. The technical component is the actual imaging. The professional component is the provider reading the imaging. If you have questions about charges on your statement, please call our Patient Financial Services department. View our contact information and office hours.

Essentia Health has locations designated as hospital-based-clinics, which are clinics located within 35 miles of an Essentia hospital. Insurance companies can list this type of location as an outpatient clinic that can incur extra charges that may become your responsibility.

Contact our Patient Financial Services office and one of our representatives will help review and resolve any billing concerns. View our contact information and office hours.

Hospitals sometimes work with other providers to enhance patient care. Often, services are performed by providers who specialize in certain areas and work alongside your primary care provider.

Please visit our Pay a Bill page to review the different payment methods.

Essentia accepts cash, checks, debit/credit cards (MasterCard, Visa, and Discover), and CareCredit.

New balances may have been transferred to patient responsibility or your statement may have been created prior to your payment posting to your account. You can view billing information through MyChart. You can also contact us during office hours.

Review your insurance policy or contact your insurance company with any questions. The insurance company is the expert on information about your policy and claim. If your insurance company has questions, please have them contact Essentia Patient Financial Services at (800) 985-4675.

Your provider may discover and/or discuss an underlying issue during your preventive exam. In these cases, the visit is split into two charges. One charge is for the preventative part of the visit. The other charge is for the health issue part of the visit. Your insurance company will then process the claim using both your preventative and medical benefits.

Contact our Patient Financial Services office. One of our representatives will answer your questions. View our contact information and office hours.

Funding for the Health Resources and Services Administration (HRSA) program has been exhausted. The program provided reimbursement for our uninsured patients with qualifying COVID-19 services, such as COVID-19 testing and treating for a COVID-19 diagnosis. This program allowed Essentia Health and other health systems to request claims reimbursement to avoid billing uninsured patients for qualifying COVID-19 visits. After learning funding would not be re-instated and finding no alternative funding options, Essentia will begin billing uninsured patients who receive COVID-19 tests and certain COVID-19 treatments starting Jan. 1, 2023. If you have questions or difficulty understanding your statement, please call us at (800) 985-4675 8 a.m. to 6 p.m. Monday-Thursday and 9 a.m. to 4:30 p.m. Friday.