Billing and Insurance
Thank you very much for choosing Lower Keys Medical Center as your healthcare provider. The administration and staff of LKMC want to ensure that the quality medical service you receive at our facility is not overshadowed by concerns or questions you may have about billing. We are aware of the high cost of medical services and the confusing nature of insurance coverage. Therefore, we have developed this summary to explain our billing process. Our admitting staff copies insurance cards and photo identification to facilitate follow-up with insurance carriers and to protect you.
Please have your cards available at time of service. Lower Keys Medical Center files insurance claims for our patients as a courtesy service. We will attempt to collect the money from the insurance company. We encourage you to contact your insurance company to assist us in the collection of your account. Many times an insurance company will pay the account more quickly if the patient assists. We will help in any way we can to work with you in arriving at an acceptable payment arrangement. However, it is ultimately your responsibility to complete the payment of your account.
The bill you receive from Lower Keys Medical Center is for hospital services only. You may also receive bills for professional services provided by your personal physician, consulting physician, radiologist, pathologist, anesthesiologist, and/or emergency room physician, if applicable.
Questions regarding these bills should be directed to the following contacts below:
- Pathology Services: (800) 853-4570
- Radiology Services: (888) 204-0468
- Emergency Room Services: (800) 355-2470
If you have any questions regarding your billing or account, please do not hesitate to contact us.
Lower Keys Medical Center
P.O. Box 9595
Venice, FL 34284-9595
We are required to have the name of your employer’s carrier and a claim number to process bills. Your employer can provide you with a Notice of Injury Form which holds this information. While we are waiting for your primary insurer to pay, the hospital will follow-up with the employer and/or insurance carrier until the account is paid. If the claim is denied, the account will be changed to a self-pay account.
The hospital will file a cliam directly to Medicare for you. We will follow-up with Medicare until the account is paid. After Medicare has processed the claim, any deductibles, copays, and/or coinsurances will be billed to your secondary (supplemental) insurance, if applicable. If there is no supplemental insurance, the hospital will collect remaining co-pays and deductibles following the Self-Pay guidelines.
Commercial health insurance / BCBS
The hospital will file a claim directly to your commercial insurance company. If payment has not been received from the insurance company within 45 days of filing, a statement is mailed asking you to follow-up with your carrier. If payment is not received within the next 2 weeks, a second statement is mailed advising insurance has not yet paid and asking for your help getting this paid. If payment has not been received by Day 150 the account will be changed to Self-Pay. If the BCBS plan coverage confirms copays and/or deductibles, they are due upfront.
The hospital will file a cliam directly to TriCare for services. If any co-pays and/or deductibles are determined by TriCare, they are due upfront. Please call if you feel you have been billed in error. TriCare for Life If you are covered by TriCare for Life, we will bill Medicare first. Any co-pays and deductibles will automatically be sent to and paid by TriCare for Life.
Medicaid / medical assistance
The hospital verifies your coverage as required and processes your account according to the policies of Medicaid and your chosen HMO. (Your HMO may restrict you to certain providers.) Copays and/or deductibles are due upfront.
Other HMO / insurance
It is your responsibility to know your insurance coverage. We cannot bill your insurance unless you provide us with an insurance card. Please be advised that some and/or all of the services provided may be non-covered services. We cannot become involved in disputes with your insurance company other than to provide billing information as necessary. Copays and/or deducibles are due upfront.
We require the name of your auto insurance carrier and a claim number to bill for services. Should you desire, we will assist you in calling your carrier while you are here to obtain a claim number. If a claim number is unavailable, you will be asked to provide us with one as soon as possible. We cannot bill your private insurance unless your auto carrier has informed us that your benefits are exhausted. Claims without the required insurance information will be dropped to a self-pay status.
If a patient does not have insurance coverage, self-pay status will be applicable. Self-pay patients are responsible for the cost of procedure/test/admit at a discounted rate on the date of service. If this is not possible patient will be required to sign an Agreement of Financial Responsibility Form and balance will be due within 3 business days by contacing the Business Office at (866) 481-2553.