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    Patient Advocate Center

    Contact Us

    How Can We Help You?

    Thank you for choosing Springfield Clinic for your health care needs. We appreciate the opportunity to deliver your medical care and hope the entire experience has exceeded your expectations. We understand that you may have questions about billing, insurance benefits, and payments.

    As of January 23, 2024, our print and online billing statements have a new look for patient visits at locations that have changed to our new electronic health record (EHR) athenahealth. athenahealth provides a modern and seamless way to access your patient information, appointments, medical history and billing statements in one platform.

    • Locations that have not yet changed to the new system will keep the current billing format.

    • Here is a resource page to help with questions about the different billing statements.

    • We will transition all Springfield Clinic locations to the new billing system in athenahealth by August 2024.

    Online

    In addition to our Monday through Friday telephone and in-person representatives, we now offer the ability to submit your questions online any time.

    We are happy to assist you usually within one business day of receiving your online question. Please complete the fields in the online form and let us know the best method for contacting you with the resolution.

    By Phone

    Call our representatives at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5:00 p.m. and Saturday 8:00 a.m. - 12:00 p.m.

    Medical interpreters are available to help patients communicate with Clinic staff. For more information, please contact Interpreter Services at 800.444.7541.

    In Person

    If you would prefer to speak with someone face-to-face, we invite you to visit our Customer Service Representatives Monday through Friday, 8:00 a.m. - 5:00 p.m. (except holidays) located at following locations:

    FAQs

    Yes – Springfield Clinic will bill your primary and secondary insurances as a courtesy when an assignment of benefits form is signed. Patients should be prepared to resolve disputed coverage issues directly with their insurer or employer.

    • Medicare – Springfield Clinic will bill Medicare and one supplemental insurance.

    • Illinois Public Aid (Medicaid) – The patient must provide a valid Public Aid card at the time of each appointment.

    • Liability Cases – Please inform the receptionist at the time of service of the appropriate liability insurance carrier. Liability Cases would include claims for auto accidents or personal injuries where another party is responsible for your medical bill. If the company name and address are available, Springfield Clinic will send the claim information to the carrier. However, the patient will be held responsible in the event that the claim is not paid by the insurance carrier within two billing cycles.

    You will receive a monthly statement when you owe a balance. This will occur after your insurance company has responded to our billing claim. Statement balances are expected to be paid in full by the due date listed on the statement.

    Any partial payment arrangement must be preapproved by contacting our representatives at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    You will be required to make a standard pre-payment at the time of service. This payment may not cover the entire amount owed for the services you receive. You will be billed for any remaining balance.

    For your convenience, we accept payments in a variety of methods. We accept cash, checks, money orders, credit cards and debit cards. Payment is due in full upon receipt of your billing statement. You can also pay in person by visiting with one of our Patient Service Representatives at select locations.

    By internet

    As of January 23, 2024, our print and online billing statements have a new look for patient visits at locations that have changed to our new electronic health record (EHR) athenahealth. To ensure you access your bill on the correct portal, visit this page. We appreciate your understanding during this time of transition. If you have questions about your bills, call us at 217.391.7086.

    By mail

    Please submit your payment in full along with the bottom portion of the billing statement in the return envelope enclosed with your bill. If paying by credit card, mark the box next to the card type (we accept Visa, MasterCard and Discover), write the card number and expiration date and sign.

    By phone

    We accept payments over the telephone via credit card or electronic check free of charge. Please contact us at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    Your online banking

    Springfield Clinic participates with several online bill pay providers used by many of the financial institutions in the central Illinois area. These relationships help to ensure that payments you initiate through your bank’s online service reach us quickly and securely.

    You may receive services from non-Clinic providers, such as laboratory services and pathology services. When this occurs, you will receive a separate bill from that provider.

    Our providers perform services at multiple facilities across Illinois. You may receive a statement from Springfield Clinic even if you were not seen at a Springfield Clinic facility.

    The parent with whom the minor children reside will be considered the responsible party and will receive all billing statements and correspondence.

    Your 18-year-old will be moved from the family account to an account established in their name. The parent will no longer be able to call a customer service representatives to discuss the child’s account without a signed Springfield Clinic consent form on file.

    If you have insurance or other account information changes that you would like to inform us about, please call us at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    There are a number of services or items we furnish our patients that are considered non-covered by health insurers. These services or items become your financial responsibility. In general, services or items that you— not your doctor—request are non-covered (example: cosmetic services). Depending on your insurance coverage, some services or items your doctor determines are medically necessary also might not be covered. Many of our providers will ask for payment at the time of your appointment for services or items they have determined are not covered by insurance.

    For our Medicare patients: you will be asked to sign an advanced beneficiary notice (ABN) which indicates you understand the service or item you are receiving that day is anticipated to be non-covered by Medicare. You may be asked for payment at the time of service.

    When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

    Ask your HR administrator if your insurance plan is fully-funded or self-funded so you know which path to take. There are network adequacy policies in place, but they must receive a consumer complaint to trigger an investigation. 

    If you are part of a fully-funded plan, you can file a complaint with the Illinois Department of Insurance on their website. If you have questions about the complaint process, you can call 877.527.9431 and press 4 for health insurance questions. 

    If you are part of a self-funded plan, you can file a complaint with the U.S. Department of Labor’s Employee Benefits Security Administration on their website or by calling 1.866.444.3272 and pressing 2 to talk to your regional office. 

    If you need help with the claims or billing complaint process, please contact the Springfield Clinic Patient Advocate Center at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    Radiology bills come from a different vendor and, therefore, payments are made to a different entity than Springfield Clinic. For help with billing questions, call 630.874.2761 from Monday-Friday, 9-11:30 a.m., 12:30-5 p.m. You can also pay your bill at www.personapay.com/ahsfcr/login.

    Please visit In-Network Insurance to stay up to date on all things Blue Cross Blue Shield.

    Financial Counselors collaborate with patients to explore options, find financial solutions and access assistance from qualifying programs. Financial Counselors answer questions related to bills and Explanation of Benefits, provide substantial discounts for uninsured and self-pay patients and help put patient's minds at ease by helping them navigate their outstanding balances. 

    Billing profile changes

    If you have insurance or other account information changes that you would like to inform us about, you can contact us by telephone at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    Explanation of Benefits

    Your insurance company should send you a form explaining what they paid on charges submitted by your physician. This form is referred to as the Explanation of Benefits, or “EOB” for short. Your Explanation of Benefits will tell you if your charges were applied to your deductible or denied for some reason. They will also tell you how much was paid, how much was adjusted off due to the contractual agreement between your insurer and your provider, and how much is left for you to pay.

    Most EOB’s show a breakdown of the charges under several headings which usually read from left to right. The most common headings are:

    • Date of Service - the date of the appointment or procedure. Services - codes used by the medical provider to tell the insurance company what services were rendered to the patient.

    • Amount Billed - the amount of charges submitted by the medical provider.

    • Approved Amount - the amount the insurance company approved for payment. Insurance companies often have pre-determined dollar amounts that they consider “usual and customary” for each medical service code. This pre-determined amount is often different than what your medical provider charges for that service. Depending on the contract or agreement between your insurance company and medical provider, or lack thereof, the difference between the Approved Amount and the billed amount may be adjusted (reduced to $0) or transferred to Patient Responsibility (see below).

    • Amount Paid - the amount the insurance company paid to the medical provider for the services rendered.

    • Applied to Deductible - the amount of charges that the insurance company has applied to the deductible. Most insurance plans require the patient to pay for a certain portion of their medical charges each plan year before the insurance coverage begins to pay. This is called the plan deductible and it comprises a portion of the total Patient Responsibility (see below).

    • Applied to Co-insurance – the amount of charges that the insurance company has applied to the co-insurance element of the plan. Some insurance plans require the patient to pay for a percentage of the charges for each medical service. This is called co-insurance and it comprises a portion of the total Patient Responsibility (see below).

    • Patient Responsibility - the amount you owe. This is made up of the deductible, co-insurance and any charges not covered by the insurance plan.

    • Denial Codes - Sometimes the insurance company will deny (refuse to pay) a charge for some reason. In this case, the EOB will contain alpha or numeric codes next to each procedure which indicate the reason for the denial. The explanation of these codes will often be found at the bottom of the page or on the reverse of the EOB. Some denial codes require the patient to contact the insurance carrier in order to resolve questions or other issues that are preventing payment from being made.

    Patient Tip:

    We recommend that you compare your insurance EOB’s to the bill received from the medical provider. Check to see if the payment was posted correctly and the amount owed on the bill matches the amount indicated on the EOB. Springfield Clinic makes this comparison easier by including detailed charge and payment information on all Clinic statements. Any questions can be directed to our representatives at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    Payment Options

    For your convenience, we accept payments in a variety of methods. We accept cash, checks, money orders, credit cards and debit cards. Payment is due in full upon receipt of your billing statement.

    Please submit your payment in full along with the bottom portion of the billing statement in the return envelope enclosed with your bill. If paying by credit card, mark the box next to the card type (we accept Visa, MasterCard and Discover), enter the card number, expiration date, and your signature.

    We accept payments over the telephone via credit card or electronic check free of charge. Please contact our representatives at 217.391.7086 Monday through Thursday 8:00 a.m. - 7:00 p.m., Friday 8:00 a.m. - 5 p.m. and Saturday 8 a.m. - 12 p.m.

    As of January 23, 2024, our print and online billing statements have a new look for patient visits at locations that have changed to our new electronic health record (EHR) athenahealth. To ensure you access your bill on the correct portal, visit this page. We appreciate your understanding during this time of transition. If you have questions about your bills, please access more information on our Patient Advocate Center page or call us at 217.391.7086.

    Springfield Clinic participates with several online bill pay providers utilized by many of the financial institutions in the central Illinois area. These relationships help to ensure that payments you initiate through your bank’s online service reach us quickly and securely.

    If you would prefer to pay your bill in-person, we invite you to visit our Customer Service Representatives Monday through Friday, 8:00am - 5:00pm (except holidays) located at the following locations in Springfield, Jacksonville and Taylorville.

    AffordaPay™

    Springfield Clinic patients with budget payment plans were notified by mail that their budget plan account balance would be transferred to AffordaPay™ for servicing and management.  AffordaPay is an extended payment program from Orion Portfolio Services, LLC, (formerly U.S. Asset Management), a national leader in health care financial services. AffordaPay™ provides financial services similar to Springfield Clinic’s budget plan program, including 0% APR and set payment amounts. AffordaPay FAQs

    • AffordaPay™ is an industry leader in healthcare financial services— not a collection agency or credit card company.

    • Through AffordaPay™, patients will continue to pay off their account balance interest free with 0% APR in manageable monthly payments. 

    • Payments options include US mail, telephone, auto-pay setup and an online account management portal - www.AffordaPay.com

    • Contact information:
      AffordaPay™
      PO box 15055

      Wilmington DE, 19850
      217.210.6682 or 855.484.3143 (toll free)
       
      www.AffordaPay.com

    • Call center hours (central time zone): Mon-Thurs, 8am-8pm  |  Fri, 8am-5pm  |  Sat, 8am-12pm

    AffordaPay by Orion Portfolio Services, LLC. A fully compliant debt purchase solutions provider

    Welcome to Orion Portfolio Services, LLC AffordaPay program. AffordaPay allows guarantors more options to pay off balances with interest free monthly payments. Our AffordaPay team looks forward to assist.

    Good Faith Estimate

    You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. If you don’t have health insurance or you plan to pay for health care bills yourself, generally, health care providers and facilities must give you an estimate of expected charges when you schedule an appointment for a health care item or service, or if you ask for an estimate. This is called a “good faith estimate.”“

    A good faith estimate isn’t a bill

    The good faith estimate shows the list of expected charges for items or services from your provider or facility. Because the good faith estimate is based on information known at the time your provider or facility creates the estimate, it won’t include any unknown or unexpected costs that may be added during your treatment. Generally, the good faith estimate must include expected charges for:

    • The primary item or service

    • Any other items or services you’re reasonably expected to get as part of the primary item or service for that period of care.

    The estimate might not include every item or service you get from another provider or facility, even if some items or services may seem connected to the same service. For example, if you’re getting surgery, the good faith estimate could include the cost of the surgery, anesthesia, any lab services, or tests. In some cases, items or services related to the surgery that are scheduled separately, like certain pre-surgery appointments or physical therapy in the weeks after the surgery, might not be included in the good faith estimate. You’ll get a separate good faith estimate when you schedule those items or services with the provider or facility, or if you ask for it.

    Your right to a good faith estimate

    Providers and facilities must give you the good faith estimate:

    • After you schedule a health care item or service. If you schedule an item or service at least 3 business days before the date you’ll get the item or service, the provider must give you a good faith estimate no later than 1 business day after scheduling. If you schedule the item or service OR ask for cost information about it at least 10 business days before the date you get the item or service, the provider or facility must give you a good faith estimate no later than 3 business days after you schedule or ask for the estimate.

    • That includes a list of each item or service (with the provider or facility), and specific details, like the health care service code.

    • In a way that’s accessible to you, like in large print, Braille, audio files, or other forms of communication.

    Providers and facilities must also explain the good faith estimate to you over the phone or in person if you ask, then follow up with a written (paper or electronic) estimate, per your preferred form of communication.

    To learn more and get a form to start the process, go to www.cms.gov/nosurprises/consumers or call 1-800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.

    *Source: Centers for Medicare & Medicaid Services ( https://www.cms.gov/nosurprises/consumers)