Frequently Asked Billing Questions

If there is a discrepancy between what was paid by your insurance and what we are billing, please contact our billing office at 270-538-5892 with your information. We will be happy to review your information with your insurance carrier to ensure the correct adjustment was made.

If there is a balance that was not covered or paid by your insurance or co-insurance, then you are responsible for the balance due as soon as you receive a bill.

In some circumstances a budget plan may be established within specific budget guidelines. Please give us a call at our billing office at 270-538-5892, Monday through Friday, 7 a.m. to 4 p.m. to discuss payment arrangements.
The budget will be set up for your account when the budget is established. Any new charges are not included in the budget and if you need to have them included, you must call our billing office to re-establish a new budget arrangement. Budgets are established per patient not per family. Please call our billing office to arrange this agreement. Bills are mailed monthly.

We apologize for this error. Please have your insurance card available and contact us during our normal business hours 7 a.m. to 4 p.m. Monday through Friday, at 270-538-5892. We will make the necessary changes to your account and re-bill the correct insurance plan.

Yes, as a courtesy we will bill your insurance company. However, Jackson Purchase Medical Associates asks that you participate in helping us to obtain necessary authorizations, insurance card copies, referrals, and other critical documentation to smoothly expedite your care and reimbursement for services rendered.

If there is a balance due from you after the insurance company has paid its portion, we will send you a bill. This bill indicates the amount that has been paid and any balance you are required to pay. This is your bill. You are required to pay this bill in full or will need to contact our office.

Before you call, have available your insurance card, date of service, facility name, original billed amount, patient name and claim number if applicable. Obtain satisfactory status of account. If paid, ask when and to whom. Note this information and with whom you spoke with at the insurance company. If the bill has not been paid, find out when the anticipated payment date is and ask if they need anything from you. If the bill is not paid in the stated timeframe, follow-up with the insurance company again and, if necessary, request to speak to a supervisor.

If you disagree with the insurance company’s payment amount, contact the insurance company, and ask them to review how the claim was processed. If the insurance company finds that an error was made, note the information and with whom you spoke with at the insurance company. Request an anticipated payment date and ask if they need anything from you. If the insurance company feels the bill was paid correctly and you still disagree, find out from the insurance company what you need to do to file an “appeal” with them. Filing an appeal will not guarantee that the insurance company will pay more on your bill, but the claim will be reviewed for reconsideration.

You will need to call our billing office at 270-538-5892. If possible, have your insurance card available when you call.

If you feel the claim has been denied in error, contact your insurance carrier for a detailed explanation on the claim. Western Kentucky Kidney Specialists will also receive an explanation of benefits (EOB) from your insurance company stating the claim has been denied. We will reflect this information on your account and a bill will be sent to you requesting payment in full.

Your insurance card indicates the billing name of the insured, but also provides other critical data for billing purposes such as: policy number, group number, plan codes, effective dates, co-pays, deductibles, referral/authorization information, physician phone numbers, insurance company phone numbers and other important information. These cards help our staff identify your coverage, since many insurance companies offer different types of plans.

Insurance carriers negotiate discounts from the provider charges. The amount of the discount is specific to each carrier. When the carrier pays their portion, the contractual allowance is deducted to reflect the true amount due from the patient.

Yes, the information on your insurance card is needed for the provider to file a claim with your insurance company or companies. When you register, we will ask for information about your insurance coverage and have you sign a few forms. This registration process goes much faster when you bring your insurance information with you.

Western Kentucky Kidney Specialists accepts Medicare, Medicaid, and most major insurance carriers. Please contact your insurance company or employer for a specific list of participating physicians.

Under a provision called coordination of benefits, a medical facility is obligated to bill the insurance that would be considered primary for you. Coordination of benefits represents the amount payable by a supplemental insurance a patient carries.