Patient Information – Billing and Insurance
Baptist Primary Care provides you and your family with comprehensive, quality medical care in addition to helping you navigate the highly complex world of billing and health insurance. Our team of trained customer service representatives is here to help you get the most for your healthcare dollar. We're here to help you …
- Find a doctor that your insurance plan covers
- Estimate your cost of alternative treatment or generic prescriptions options
- Navigate your insurance plan's pre-authorization requirements
- Find answers about your bill and our general billing process
- Be a savvy healthcare consumer
Participating Health Insurance Plans
If you have a participating health insurance plan and provide us with your policy information, we will file your insurance claims for you. Please advise us of any changes to your insurance information or mailing address.
You will be responsible for any co-pay, co-insurance, deductible, or non-covered services at the time of each visit. We accept cash, check, Visa, Mastercard, Discover
and selected offices accept American Express. When your statement of benefits arrives from your health insurance company, please verify that payment has been made. Ultimately, payment responsibility rests with the patient. If you have any questions about your bill, please contact
us at 904.202.1032.
If we don't currently accept your health insurance plan, you will be responsible for filing your claim and for making payment in full at the time of each visit. If you do not have health care coverage you will be asked to pay a portion of your estimated charges at the time of service. You may contact customer service to discuss available payment options.
Online Bill Payment
For your convenience, you may pay your primary care bill using our online bill payment service. We accept online payment using Visa, Mastercard and Discover cards.
Understanding Your Health Insurance Plan
Taking time to understand your health insurance plan and knowing what your health insurance policy does and doesn't cover can improve the care you receive and reduce your costs. Your health insurance policy is an agreement between you and your insurance company. The insurance policy lists what tests, drugs and treatments are "covered" -- those the insurance company will pay for. The policy also lists which services aren't covered.
In some cases, preauthorization is required for certain services to be covered. You or your doctor will need to call your health plan before services are rendered. When in doubt, call your insurance company before seeking treatment.
For more information, refer to your plan's documentation:
- Filing a claim. This section gives instructions on how, where and when to file a claim.
- Filing a complaint or grievance and how grievances will be resolved.
- Coverage periods. This gives specific information about when your coverage begins and ends.
- Definitions of terms as used in the policy. This is where you'll find what the company considers a "covered member," "medically necessary" and "usual and customary charges," among other terms.
- Eligibility for coverage and when and how to enroll. This section will include details on how to enroll your spouse, newborn child, teenager at college, etc.
- Schedule of benefits. This section contains a detailed list of covered plan services and the amount or percentage payable, including any maximum benefit. It lists specific conditions, services, procedures, tests, supplies and facilities covered.
- Exclusions and limitations. Specific conditions and procedures the policy will not cover are detailed in this section. Common exclusions include: preexisting conditions (conditions that occurred before you were covered); coordination of benefits (rules that dictate what your plan will cover if you're also covered by another plan); Veterans Administration or workers' compensation (what conditions or accidents these payers cover)
- How to appeal. This section will tell you how to challenge a decision if your insurance company denies your claim.
Frequently Asked Questions
How may I pay my bill?
What credit cards are accepted?
What is an electronic check or eCheck?
An electronic check and eCheck are the same thing. Both refer to an electronic version of a paper check, used to pay a bill over the Internet. To pay by electronic check (eCheck), you will need to know your bank routing number (found on bottom left corner of your check) and your checking account number (found to the right of the routing number on your check). This electronic check will be treated as if you had written a paper check and the amount will be deducted directly from your checking account.
What information will I need to pay my bill online?
Is there a fee for making my payment online?
Is this website safe for credit card transactions?
I tried paying my bill online, but it's not working. Why not?
Although all outstanding Baptist Primary Care and Baptist Pediatrics bills will eventually be enabled for online payment, currently, only bills generated since May 10, 2010, are recognized by the online payment system. If your bill was generated before May 10, 2010, you can still pay by phone (credit card), mail or at your physician's office.
Who can I talk to regarding questions or concerns with my bill?
You can discuss your bill by contacting a Customer Service representative at one of the below phone numbers. Email addresses are also provided for your convenience.
| |
Phone |
Email* |
| Baptist Primary Care |
904.202.1032 |
BPCbilling@bmcjax.com |
Baptist Pediatrics
(San Jose & Ponte Vedra) |
904.737.7668 |
bappedsbill@bmcjax.com |
| Baptist Obstetrics and Gynecology |
904.376.4048 |
|
| Baptist Behavioral Health Outpatient |
904.376.3800 |
|
*When sending an email, please reference your account number in the subject line.
Do you accept my insurance plan?
Will I be required to pay anything when I arrive?
Upon arrival, you may be asked to pay a deductible or co-pay depending upon your insurance plan. If you do not have health care coverage, you will be asked to pay a portion of your estimated charges at the time of service.
Who should I contact if I have an insurance related problem?
How will I know if my insurance company has paid my bill?
After your insurance receives and processes your claim you will receive an Explanation of Benefits (EOB) explaining how your claim was handled. The EOB will show amount of payment, patient responsibility and/or denials. If there is a patient responsibility due, we will send you a statement.
Why didn't my insurance pay for some services?
What if I disagree with how much my insurance paid on my bill?
Contact your insurance company directly. Be sure to note the name of the representative you have spoken to. If an error has been made, request the insurance company provide you a timeframe of when the correct payment will be received. If your insurance indicated the bill was paid correctly, request information on how to appeal the decision. An appeal will allow the payment to be reconsidered, however this is not a guarantee payment will be made.
