Blue Cross Policies
It is our policy to bill all Blue Cross plans for inpatient and outpatient services, if you provide proof of insurance (i.e. an insurance card) at the time of service.
Many insurance plans require prior approval for services by patients and/or their Primary Care Providers (PCPs) before services can be covered. This is often referred to as pre-authorization.
Commercial insurance plans also generally have deductibles, co-pays, and/or coinsurances.
- A "deductible" is an annual expense that you must pay before your insurance benefits can begin. This amount can vary based on place of service (i.e. your doctor’s office vs. a large hospital). Supplemental insurance plans may cover this cost.
- "Coinsurance" is the portion of the total bill (usually a percentage) that is the patient’s (or guarantor’s) responsibility to pay. This amount can vary based on place of service (i.e. your doctor’s office vs. a large hospital). Supplemental insurance plans may cover this cost.
- A "co-pay" is a set amount paid each visit, based on your insurance policy. This usually does not count toward your deductible.
Before your visit to a Northern Light Eastern Maine Medical Center, please review your health-plan booklet or call your Blue Cross representative to clarify your specific policy benefits and requirements. Many insurance carriers also have their own web sites – information about your company’s website can be found in your insurance policy handbook, on your insurance card, or at your benefits office.