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Insurance, Billing and Payment

Patient Account Services

We know insurance and billing can be overwhelming and we are happy to help. At BPS, we have a team available to assist you with your insurance, billing and payment questions. We’ve gathered the information people need most here. Please review the content to see if we’ve addressed your question. If we haven’t, please contact us.

We are available to assist you Monday through Friday, 8 a.m. to 5 p.m. at 1-877-599-1039. We can also be reached by email at paymybill@bluestonemd.com.

Advance cost estimate notice for private pay patients

If you are an uninsured or a private-pay patient, BPS currently does not provide services to this population. We would encourage you to utilize county, Medicare/Medicaid or the Health Insurance Exchange Marketplace to explore health insurance coverage options should you wish to receive medical care with our organization.

Patient Financial Agreement

Please read the following information closely. Although we contract with a variety of government, managed healthcare plans, and commercial insurance companies, we want to be sensitive to our patients. We have team members available to work through individual financial situations.

If you have any questions, please ask as we want to ensure that you completely understand our financial policies.

Patient Financial Agreement


Accepted Insurance Plans

We are contracted with most major insurers, including Medicare and Medicaid. Included below is a list of those insurance plans, by geographical market, that are currently in network with BPS. Please be sure to notify Bluestone Physician Services right away if your insurance changes in any way.

Florida List of Accepted Insurances

If your insurance plan is not listed, we may still participate through one of our network contracts. Please call our Billing Department for additional information.

(Please note: Due to federal government restrictions, we are not allowed to answer questions about specific plans or to make plan recommendations.)

Co-payments and deductibles

We are required by Medicare and insurance companies to collect appropriate copays and deductibles. Please speak with a member of our patient account services team if you have any questions about this requirement.

Managed-care insurance

We will need to know if you are covered by a health maintenance organization (HMO), preferred provider organization (PPO), or another managed-care plan. We will verify the conditions of your insurance coverage and confirm our participation in your plan before care begins.

Pre-Certification

Some insurance plans require prior approval of hospitalizations, referrals, or procedures. This is usually a requirement in managed-care coverage.

Our care team at BPS will send the insurer the necessary information. We want to ensure that all approvals are in place so that you receive the maximum payment from your insurance carrier to decrease your out-of-pocket expense.


How health insurance billing works

After your visit, Bluestone Physician Services will bill your insurance carrier on your behalf. In order to do this, we will need a copy of your insurance card with complete and accurate information about your health plan.  We will also need you full name, address, phone number, date of birth and insurance identification number. If any of this information is incomplete or incorrect it could result in a denial from your insurance carrier. The accuracy of this information is the patient’s responsibility; therefore, you could be held responsible for the balance if your carrier denies it due to inaccurate or incomplete information.

The insurance carrier will notify BPS of the amount of your visit that is covered by insurance and what has been determined to be patient responsibility (co-pays, co-insurance, or deductible amount). At that point, you will receive a bill for the remaining balance. That balance is due as soon as you receive the first account statement from BPS.

Please note that the timeline for insurance processing varies by the insurance company. As a result, you may not immediately receive a bill. Do not assume that if you have not yet been billed, that there is no balance due.


Medicare

Learning about Medicare options can be overwhelming. We would like to help you make an informed choice that makes the most sense for you and your health.

Things to consider when choosing a Medicare health plan include

  • Can I continue seeing my existing healthcare team on the health plan I am considering?
  • Are my prescriptions covered by this plan?
  • Is my pharmacy in this plan’s network?
  • Am I able to get the care I want for a cost I can afford?
  • Does this plan include the benefits that are most important to me?

To compare your current Medicare or Medicare Advantage health plan to the health plans we currently accept, please visit Medicare’s Find Health & Drug Plans to begin your search. Medicare covers a “Welcome to Medicare” preventative visit, as well as a yearly “wellness” visit.


Medicare Advantage

We believe the best way to be healthy is to stay health. That is why we encourage our Medicare patients to choose a Medicare Advantage plan accepted by Bluestone Physician Services. Medicare Advantage plans help you and your provider work together to keep you healthy through prevention, care coordination and disease management. More than [insert patient figure] are benefiting from Medicare Advantage plans.

  • Medicare Advantage plans must, at a minimum, provide the same benefits as Original Medicare.
  • Many Medicare Advantage plans include additional services and benefits not provided by other Medicare programs (i.e. vision, dental, gym memberships).
  • The Medicare Advantage plans we contract with encourage disease prevention and chronic care management which significantly improves the quality of care and reduces overall healthcare costs.
  • Prescription drug (Part D) coverage is also included with most Medicare Advantage plans, providing the convenience of one bundled product.
  • With Medicare Advantage, you will not need Medigap (supplemental) coverage.

Communicate with your insurance carrier

We encourage contact with your insurance provider to inform them of your decision to receive services through BPS and to learn more about your coverage and the specifics of your insurance plan.

Questions to consider asking your insurance carrier:

  • Is preapproval needed for hospital admissions, diagnostic tests, or imaging scans? If so, what’s the process?
  • What rules or guidelines are there for getting a second opinion?
  • What is the process for filing claims?
  • What if any, deductibles must be met before the insurance begins paying claims, including those for prescriptions and lab work?
  • Does my insurance policy have limits on what they will pay for Behavioral Health, or Psychiatric services for example?
  • Does my policy cover new treatments or participation in clinical trials? If so, are there any limits or limitations?

Payment options for out-of-pocket costs

Payment for your visit and services are due upon receipt of your billing statement and are due in full. This includes co-payments, co-insurance, and unmet deductibles. There are several convenient options for you to make a payment:

By phone

MI/WI Market 651-472-8172

FL Market 813-324-5253

Postal mail

For payment by mail, please include your patient account number on the memo line to:

 

MN/WI Market Statements

Bluestone Physician Services PA

270 North Main Street, Suite 300

Stillwater, MN 55082

 

Florida Market Statements

Bluestone Physician Services FL

10150 Highland Manor Drive, Suite 240

Tampa, FL 33610


FAQ’s

What is a health insurance network?

A health insurance network is a group of doctors and medical care providers across multiple specialties that have a contract to provide health care services to members of a health insurance plan.

What is In-Network (INN)?

When you see a doctor, who is in-network, you are using a provider who directly contracts/participates with your health insurance plan. Some health insurance plans only cover INN, while others cover both INN and OON care. If your health plan covers OON too, staying INN often still reduces the amount you may pay for health care.

What is Out-of-Network (OON)?

OON means that the doctor or health care organization does not have a contract with your health insurance plan carrier. This can sometimes result in higher prices.

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