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Billing & Insurance

Learn More About Our Services

McKenzie Health System's commitment to your healthcare and respect for your time doesn't stop with patient services. It continues through all administrative departments as well.

Payments can be made in person or on our website at www.McKenzieHealth.org/Pay.

If you or someone from the community has questions or would like to pay their bill via phone, please call 810-648-6199.

About Your Health Insurance

We know that insurance and financial issues can be confusing and stressful. We are providing the following information to help you in understanding your financial responsibility and our relationship with your insurance carrier.

Accepted Insurance

McKenzie Health System participates with many medical insurance plans. Your insurance policy is a contract between you and the insurance company. If you have questions about what services and providers are covered, if referrals or prior authorization is required, or if you will have any out-of-pocket expenses, you should contact the insurance company.

Our team will submit a claim on your behalf, but that is not a guarantee that the claim will be paid. If your claim is rejected or only partially paid, your insurance company should send you an explanation. It is your responsibility to pay any balance not covered by insurance. If McKenzie Health System does not participate with your insurance plan, payment is expected at the time of service.

Here is a List of Insurance Programs McKenzie Health System accepts.

Referrals and Authorizations

Many medical insurance plans require a referral or prior authorization of a condition for coverage of services.

A "referral" is permission from your primary care physician and your health plan to see a particular provider or to have specific procedures done.

An "authorization" is often required for procedures such as surgery or CT scans. If your plan requires a referral or authorization, it must be obtained prior to services being rendered.

Some insurance plans require that services such as laboratory work, X-rays, and physical/occupational therapy be performed at specific sites. It is the patient's responsibility to know which site you must use for tests and services. If you have questions, contact your health plan for the most accurate information.

Multiple Insurance Plans

If you have multiple insurance plans, those plans must agree on a Coordination of Benefits order. This determines what insurance program will be billed as primary and secondary for your covered services. Some insurance companies require patients to verify this order every year. Please be sure to complete any Coordination of Benefits paperwork you receive in a timely manner.

Assignment of Benefits

If we file a claim on your behalf, payment will be made to McKenzie Health System. However, if your insurance plan does not allow you to assign benefits and will only make payment to the insured, you will be required to pay in full for all services rendered.

About Payments

Co-pays, deductibles, co-insurances and fees for non-covered services are expected at the time service is provided.

For your convenience we accept cash, personal checks, Visa, MasterCard, Discover, American Express and debit cards. More information is available by downloading our Financial Policy Brochure.

Financial Counseling

McKenzie Health System provides financial counseling services to patients regarding their ability to pay. If you are uninsured, have concerns about your account, or have other questions concerning your financial obligations, please contact us at 810-648-6199. Financial Assistance may be available.

About the Billing Process

Patients will receive one monthly statement for all services from the hospital. Bills are sent as soon as possible after receiving services from their physician or the hospital. Typically, bills are not sent until all insurance claims have been processed. It is important to note that patients are not billed more than once for the same service, however two different bills may be received, a hospital bill and a physician bill.

Hospital Bills

McKenzie Health System bills patients for hospital-based procedures and hospital stays. This includes such items as the daily hospital room rate, medication, and services performed by hospital personnel.

Physician Bills

Your physician bills for services provided by the doctor. If you had diagnostic testing done that required a physician to interpret the test, such as radiology services or an EKG, you will receive a separate bill for the physician’s services.

Once a bill is received, patients have 20 to 30 days to pay the bill in full, depending on the procedure or service. The due date will be noted on your bill. McKenzie Health System can arrange flexible payment options or can provide information related to a loan application from an outside company.

Questions?

If you have questions about your hospital bill, contact McKenzie Health System during office hours (Monday-Friday, 8:00 a.m. - 4:30 p.m.) at 810-648-6199 and ask for the patient account representative.

You can also visit our offices at:

McKenzie Billing & Insurance
394 Loraine Street
Sandusky, MI 48471
See map: Google Maps

About Hospital Charges

As of January 1, 2021, all hospitals are required to post their current standard charges and negotiated reimbursement amounts on the internet. Hospitals are paid by health plans and/or patients, but the total amount paid is significantly less than the standard charges due to individual contractual agreements with health insurance companies. Hospitals are also required to post information for items designated as “CMS Shoppable” as well as the “Top 300” items for the specific hospital. The “CMS Shoppable” items must be listed whether they are offered at the specific hospital or not.

Charges are based on what type of care is provided and can differ from patient to patient for the same service depending on any complications or different treatment provided due to the patient’s health. Therefore, actual charges for a specific patient will differ from the listed standard charges. “Comparison shopping” based on the posted standard charges can be difficult because many tests and procedures are comprised of numerous components from several different departments such as laboratory, diagnostic imaging, pharmaceuticals, supplies, therapies, etc. Please click one of the links below to view the CMS Shoppable items, Top 300 items and all standard charges and negotiated reimbursement amounts that are current as of January 1, 2021:

If you need an estimate for a specific test or procedure, please contact the hospital Insurance Services staff during normal business hours at 810-648-6119. Ask your provider for the technical name of the test/procedure recommended as well as the specific CPT and ICD codes for the service. While the estimate is not a “quote” of exact charges, it is a guideline of the estimated charges based on the tests/services ordered by your provider with the information available at the time of the estimate. Actual charges and amounts may vary.

Many patients who seek hospital charge information are interested in knowing what their out-of-pocket financial responsibility will be. This will depend on the specifics of their health plan, please see About Your Health Insurance above.

If you are concerned about the cost of services, please click here for information about Financial Assistance. No person, regardless of ability to pay, will be refused emergency medical services in accordance to Internal Revenue Section 501(r)(4).

For more information about hospital charges or to get an estimate, please contact the hospital Insurance Services staff at 810-648-6119.