Health Insurance and Financing your care
How can I verify coverage of my treatment with my insurance?
Each year employers provide insurance plan options during the open enrollment period. While considering your choices, you may want to verify that Rogers will be covered within the available plans as this can change from year to year.
If it is determined that one of Rogers’ programs meets your needs, an intake specialist will request a benefits quote from your insurance provider with your permission. This quote is not a guarantee of coverage as each insurance plan has varying restrictions for benefit availability, service providers and medical necessity criteria.
We strongly recommend that you contact your insurance benefit company to verify your coverage prior to seeking treatment. Call the toll-free number on your insurance card to inquire about your coverage for behavioral healthcare, medical services and prescription drug coverage. It’s important to have a clear understanding of your coverage and any restrictions.
Which insurance companies include Rogers Behavioral Health in this benefit year?
Rogers is contracted with many national health plans, including most Aetna, Blue Cross and Blue Shield, Cigna, Humana and United plans. Rogers is also an approved provider for Ontario and British Columbia’s Health Ministries. Some exclusions may apply. Please contact admissions at 800-767-4411 for the most current information.
Medicare covers only inpatient services and coverage varies by age and health maintenance organization (HMO) enrollment. Medicaid coverage is dependent upon age and levels of care (exclusions apply).
T19 Molina, Network Health, Managed Health Systems and Cenpatico are covered at other facilities, please contact your insurance company for a list of providers. T19HMO questions can be directed to patient financial services.
For non-contracted insurance plans, you may attempt to obtain a single case agreement (SCA) through your insurance company. A SCA is a contract with an out-of-network insurance provider who has agreed to a specific one-time rate for your care.
Is a deposit required for admission?
Under certain circumstances, a deposit may be required. In most instances, your deposit will be equivalent to your remaining deductible, out-of-pocket, and/or copay (whichever may apply). Unused portions of your deposit and/or additional prepayments will be refunded to you after the claim is processed by your insurance provider(s).
Can I use a credit card for a deposit?
Yes. We accept American Express, Discover, MasterCard and Visa. We recommend calling your bank prior to admission to inform them of the upcoming charge.
Has my claim been sent to my insurance company?
We bill your insurance company within 45 days. Any bills you receive from us should reflect payments made by your insurance provider.
Insurance coverage requires adequate insurance information upon admission. If you did not initially provide insurance information to admissions, it has been longer than 60 days since discharge and your insurance company does not have a record of the bill, contact Patient Financial Services.
Can I set up a payment plan for my balance?
Contact Patient Financial Services to apply for a payment plan.
I think my bill was already paid. Why am I still receiving a statement?
If you recently mailed your payment, your check and bill likely crossed in the mail. If you receive another statement, please contact Patient Financial Services.
What if I need a copy of my bill or I do not understand my bill?
We would be happy to issue a duplicate bill and/or answer your billing questions. Please contact Patient Financial Services.
Will I receive one bill for the total cost of my care?
In many cases, you will receive more than one bill for separate charges from the hospital and your doctor, as well as additional lab, medication and diagnostic fees from our third party partners.
How much does treatment at Rogers Behavioral Health cost?
Our insurance pricing calculator can help you estimate the out-of-pocket costs of your care (the amount you can expect to owe for your treatment). The federal government requires us to post standard charges for inpatient and outpatient services and items we provide, and this tool goes beyond that requirement to help you estimate the cost based on your insurance plan including co-pays and deductibles. If you need help with your bill, click here to find information about our Financial Assistance Policy.
To help you better understand healthcare services, the cost of care, and comparison shop between hospitals, additional information is available at wipricepoint.org.
Upon admission, Patient Financial Services will ask for your health insurance information, either in person or over-the-phone. Please have your medical insurance card with you when admitting to Rogers or calling Patient Financial Services.
Pre-Authorization, Pre-Certifications and Out-of-Network Coverage
Your insurance coverage may vary based on your:
- Pre-authorizations and pre-certifications: To provide coverage for your care, most insurance providers require authorization prior to admission. Even if your treatment at Rogers is entirely covered and you have a quote of benefits for the program, your stay may not be covered unless authorization is obtained. This means you may be financially responsible for your care.
Upon arriving for admission, we will notify your insurance carrier of your admission to request authorization. The authorization process can take 30 minutes to 72 hours.
Instead of waiting for insurance authorization, you may sign an insurance status form stating you understand the authorization has not yet been obtained, but wish to proceed with admission.
For authorization questions, contact Admissions at 800-767-4411.
- In-network coverage: Admissions will communicate with your insurance provider to determine which services are covered under your policy. In many cases, you may contact your insurance company directly to verify coverage.
- Out-of-network: Your insurance company may limit reimbursements using their parameters for cost of services, also known as UCRs (usual, customary and reasonable). Rogers’ service fees may differ from your insurance company’s defined UCRs. If so, you are responsible for the amount not covered.
You may contact your employer or insurance provider for questions about coverage. Although we may assist, it is ultimately your responsibility to verify and understand the terms of your policy. This may require working directly with your insurer.
Patient Financial Services will file claims with your insurance provider on your behalf. You will need to fill out a release of information form upon admission to allow us to do so.
If you are covered by more than one insurance plan, we will file claims with both companies. One insurance plan will be your primary insurance and the other will be your secondary insurance. In some cases, you may use Medicare in addition to your primary and/or secondary insurance plans.
For primary and secondary insurance claims:
- Patient Financial Services will file your primary and secondary insurance claims for you. Once your primary insurance provider has paid, we will send a claim to your secondary insurance. To best help you, you will need to fill out a release of information form upon admission.
- Ultimately, it’s your responsibility to coordinate billing and payment information with your insurance provider(s).
For Medicare claims:
- Patient Financial Services will file your Medicare Parts A and B supplemental insurance claims.
- Medicare will send some claims to your supplemental insurance. You will need to notify Medicare if there are any changes in your supplemental insurance plan.
- Medicare will send payments directly to Patient Financial Services.
- You will receive an explanation of Medicare benefits directly from Medicare.
If you received treatment from more than one program or provider, you may receive more than one bill. Even if you were treated within the same Rogers hospital or clinic, you may receive separate bills from the hospital and doctor.
The payments you and your insurer make during the billing period are listed separately on your bill. The balance you still owe is also listed.
Types of bills you may receive:
- Hospital and Physician bills: Rogers will bill for both the facility and the physicians. For questions about a bill you received from us, please contact Patient Financial Services.
- Wisconsin Diagnostic Laboratories or Millennium Labs bill: Rogers uses third party diagnostic laboratories for our lab services. Lab fees are billed separately for residential, partial hospital and intensive outpatient care. For questions regarding your lab bill, contact the billing department of the lab who sent you a bill: Wisconsin Diagnostic Laboratory’s at 414-805-7656 or Millennium Labs at 877-451-7337.
- Genoa Pharmacy Medication bill: Rogers uses a third party pharmacy for some medication services. Medication fees are billed separately for residential, partial hospital and intensive outpatient care. For questions regarding your medication bill, contact Genoa Pharmacy’s customer service department at 888-436-6279.
- Quest Diagnostics Laboratory: Rogers uses a third-party diagnostic laboratory, Quest Diagnostics, for our lab services. Lab fees are billed separately for residential, partial hospital and intensive outpatient care. For questions regarding your lab bill, contact Quest Diagnostics’ billing department at 866-697-8378 or via email.
*Rogers enters service level agreements with all third party vendors to ensure they reflect our mission while interacting with our patients. If you have been treated unfairly, please contact Patient Financial Services immediately. We will address concerns with our third party vendors on your behalf.
If you do not have health insurance, contact Patient Financial Services to learn more about financial assistance provided by the following programs:
- Financial Assistance Program
- Rogers Behavioral Health Foundation Grants and Scholarships
Our admissions team can answer your questions and help you begin the process of applying for treatment.
What to bring
We have a general list of items you or your loved one will need during the treatment stay.