Improving the health of the community is central to everything The MetroHealth System does. How
MetroHealth fulfills that mission is also important. Service, accountability, respect and equality are among MetroHealth’s core values.
MetroHealth supports the Patient Financial Bill of Rights. And here’s how.
As a MetroHealth patient, I have:
1. The right to accurate and up-to-date information about MetroHealth’s participation in my insurance plan’s provider network.
- I know I can obtain this information by calling MetroHealth’s Customer Services at 216-957-3250 Option #2.
2. The right to collaborate with MetroHealth to understand the No Surprises Act.
- For more information about your rights under federal law, visit www.cms.gov/nosurprises/consumers.
- If you believe you’ve been wrongly billed, you may contact the Department of Health and Human Services at 1-800-985-3059 or visit www.cms.gov/nosurprises.
- Ohio laws also protect patients against balance billing by out-of-network providers. For more information visit No Surprises: Understand your rights against surprise medical bills | CMS
3. The right to not be charged for covered preventive care services.
- Preventive care keeps me and my family healthy. I know that many preventive care services are free under the law and that I will not be charged for these services. This link provides guidelines based on governmental preventive care visits at Medicare Preventive Services (cms.gov)
- However, if my insurance does not pay, I know I can call MetroHealth’s Customer Advocacy Department to assist me.
4. The right to be informed, in advance, of any facility fees.
- I understand that receiving care at hospital outpatient departments means that I have convenient access to more services and procedures.
- I know that I may receive two charges on my MetroHealth patient billing statement for the same date of service: one for where I receive my care/service and one for who provides it. For example, if I get an x-ray, I may receive a charge for where it is performed (the facility) and another charge for the clinician (the radiologist) reading the results.
5. The right to see a price estimate for services and a price list for elective procedures.
MetroHealth offers an online “My Cost Estimator” tool that allows me to receive price estimates based on my coverage. I can find that tool at: MyChart - Patient Estimates (metrohealth.org)
I will be able to review estimated costs for potential or scheduled services to help me understand my benefits and my out-of-pocket responsibility.
I will have access to a MetroHealth financial specialist who can assist me by calling 216-957-2325 Option 3.
6. The right to be informed of lower-cost options.
MetroHealth seeks to provide me with choices – choices in location, types of procedures, and medications that may help me.
I can contact 216-957-2325 Option 3 to know what other options might be available for me.
BILLING • CUSTOMER SERVICE ADVOCACY • FINANCIAL COORDINATION
7. The right to be informed about, and given access to, financial-assistance/financial-coordination programs and reduced-price care programs.
- MetroHealth has always maintained a compassionate financial assistance policy.
- I have the right to have my personal financial circumstances confidentially reviewed to see if it might qualify for assistance.
- I deserve a process that is respectful, dignified and patient-centric with the goal of ensuring my uninterrupted care.
- MetroHealth also maintains answers to frequently asked questions online at: www.metrohealth.org/patients-and-visitors/billing/billing-faq.
- MetroHealth is available to answer my questions about potential financial assistance programs via phone at 216-957-2325 Option 1 or toll free 877-509-0597.
8. The right to receive a clear billing statement, in language I understand.
- I know I will receive an Explanation of Benefits from my insurance company. This is not a bill. The Explanation of Benefits will list all charges, which ones will be paid by insurance and what, if anything, I owe.
- If I owe something for my care, MetroHealth also will send me a statement after my insurance company processes the claim, which will clearly state how much I need to pay.
- If I owe nothing, I will NOT receive a MetroHealth patient statement.
- I can request additional information about my health care coverage, including my out-of-pocket responsibility, by calling 216-957-2325 Option 3. My responsibility will depend on my personal coverage.
- If I do not have insurance, I will receive a MetroHealth patient statement reflecting my responsibility for payment.
9. An accurate itemized bill.
- Typically, only my insurer receives an itemized bill. However, I know I have the right to request MetroHealth to provide me with the same detailed bill.
- I can request an itemized bill on MyChart, by email or by mail.
- I know that I can call the Customer Advocacy Department at 216-957-3250 Option 2 if I would prefer to speak with someone and get clarification.
10. The right to know that if I dispute a bill, it will not be sent to a collection agency
- MetroHealth offers many payment options, including payment plans with 0% interest. I know that I can contact the Customer Advocacy Department at 216-957-3250 Option 2 to find out more about these options.
- MetroHealth also will carefully and thoughtfully review any bills I dispute – and will not send the bill to a collection agency while it is being reviewed.
- I understand that overdue bills that are not disputed may be sent out for collection.
11. The right to be informed of any conflicts of interest.
- MetroHealth maintains rigorous conflict-of-interest policies and oversight.
- I will be informed of any conflicts of interests involving my providers.
Customer Service Advocacy (Billing)
Preventive Care Services
No Surprises Act
- For more information visit www.cms.gov/nosurprises
- If you have questions for MetroHealth please reach out to one of the departments listed above regarding your specific question
Watch a video to help understand cost, coverage, charges, billing and your rights as a patient.