BILLING AND INSURANCE

Healthcare billing, insurance, and Medicare can be confusing. At Black River Health, we strive to make the process as easy and patient-friendly as possible. Our Fiscal Services Department is happy to assist with any billing or insurance questions. Its hours are 7 a.m. to 4:30 p.m. Monday through Friday.

Important Information About Your Bill

 
Black River Health

As of December 30, 2024, Krohn Clinic and Black River Memorial Hospital officially joined to become Black River Health.

 

What This Means for Your Bill

The Krohn Clinic campus now offers services that are billed in two ways:

  • Clinic Services
  • Hospital Outpatient Services

Depending on the care you receive, your bill may look different, and you may owe separate charges.

 

What’s Changing? 
  • Clinic Visits: Routine appointments with your primary care provider will continue to be billed as before.
  • Hospital Outpatient Services: Services such as Lab, Imaging, Podiatry, Orthopedics, Oncology, Nurse Visits, and Surgical/Procedure areas are now classified as hospital outpatient services. These may include two separate charges:
    • Facility Site Fee
    • Professional Fee

 

What Are Facility Site Fees?

Hospital-owned clinics, also known as provider-based clinics, are considered an extension of the hospital. To meet strict safety standards and regulatory requirements set by Medicare, Medicaid, and The Joint Commission, these clinics charge a facility fee. Both government agencies and commercial insurers require that this fee is billed separately from the provider’s professional fee.

If you receive care at a hospital-owned clinic, you will receive two bills: one for the facility fee and one for the provider’s care.

What Are Professional Fees?

This is the fee for the care provided by your physician or healthcare provider.

 

What Do Facility Site Fees Cover?

Facility fees cover the costs of operating the clinic, excluding the provider’s professional fees. These costs include:

  • Equipment
  • Utilities
  • Maintenance
  • Supplies and medications
  • Non-physician staff care

Facility fees also help cover the cost of meeting strict safety standards and regulatory requirements. They may contribute to the training of physicians, nurses, and other healthcare professionals.

 

Will My Insurance Company Pay the Facility Site Fee?

Most insurance companies will cover facility fees, but some may not. Before your visit, contact your insurance provider using the customer service number on your card to confirm whether your plan covers these fees.

Some insurance plans also may process hospital outpatient services differently, which may result in higher out-of-pocket costs (increased copays or deductibles).

We strongly encourage all patients to:

  • Review your health insurance benefits
  • Contact your insurance provider to understand what’s covered and what you may be responsible for based on the type of services provided.

 

Need Help Understanding Your Bill?

Our Patient Financial Advocates are here to help.
Call us at 715-284-1368 or 715-284-3691 for assistance.

 

 

For payment on services received prior to 12/30/2024 at Krohn Clinic Ltd, please call (715) 284-4311.

For all other inquiries:

 

MEDICARE/MEDICARE ADVANTAGE/MEDICARE HMOS

Black River Health, Inc. will bill Medicare for your services. If you present supplemental insurance at the time of registration, we will file your insurance for any balance that was not paid by Medicare. You will receive a monthly statement for any personal balance not covered by Medicare or your insurance.

 

MEDICAL ASSISTANCE

Medical assistance cards are required at the time of registration. This is a state regulation, and if you do not show your card the charges could become your personal obligation. There is a daily co-payment for hospital services.

 

INSURANCE AND HMOS

Black River Health, Inc. participates in many of the Managed Care Plans offered in our area. Some insurance plans may require a referral or pre-authorization for certain tests or procedures. It is your responsibility to understand the requirements of your plan. If you have any questions about your policy, contact your insurance company's customer service department.

The Fiscal Services Department will bill your insurance company as a courtesy to you if complete billing information was given at the time of registration. We will make every attempt to resolve any billing issues with your insurance company; however, if you receive a statement and our billing office has exhausted all efforts for payment of your claim, you will be responsible for the balance of your account.

 

PATIENT BALANCES

For charges not covered by insurance, we accept cash, personal checks, Visa, MasterCard, and Discover. You can pay your bill online. We also can set up a payment plan for your convenience. A Patient Financial Advocate is available Monday through Friday to answer any questions you may have. Please call 715-284-1368 or 715-284-3691 to schedule an appointment.

 

FINANCIAL ASSISTANCE

Patients who are unable to pay for their hospital services should apply for the hospital's Financial Assistance Program. 

 

STATEMENTS

Statements are prepared and mailed out monthly. If you have any questions regarding your statement please call 715-284-5361 and ask to speak with a Financial Services representative. Detailed bills are available by request.