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Common Insurance Coverage Questions

​​​​​​​​​​​​Insurance coverage can be confusing. Here are some helpful tips to guide you through the billing and insurance process.

​Does Marshfield Clinic accept my new insurance carrier?

​This list will show you all the insurance plans​ that Marshfield Clinic has agreed upon contracts with.

Call your insurance company for assistance understanding your benefits. You can usually find their phone number on your insurance card.

I have new insurance. What are my benefits? 

Call your insurance company for assistance in understanding your benefits. Check your insurance card for the appropriate phone number to call.

How do I update or make a change to my insurance?

Marshfield Clinic's Insurance Eligibility Help Line is here to gather, verify and enter your insurance information.

They can assist you in meeting insurance referral requirements, update your insurance information or provide guidance when selecting contracted insurance companies.​​

Contact Insurance Eligibility Help Line: 1-800-782-8581 Ext. 7-5559​

Is my procedure covered by my insurance company?

Your health plan may require certain services to be authorized, or pre-certified before you receive those services.​

Even if a procedure is approved, you may be responsible for out of pocket expenses, e.g., deductible, copayment, or coinsurance. You may wish to review your benefits handbook or review your benefits with your insurance company.

Insurance benefits and service coverage

Marshfield Clinic's Managed Care Coordinators will call your insurance company for you to verify your benefits for certain services. ​

​We encourage you to contact your insurance company for benefit information specific to you (phone number located on your insurance card).​​

Contact a Care Coordinator: 1-800-782-8581 Ext. 7-5559

Referral and prior authorization

Many insurance plans require prior approval for care. On request, our Patient Assistance staff​​​ can help you get prior approval. 

Even in cases where the procedure is approved, you may be responsible for out of pocket expenses such as, deductibles, copayments or coinsurance. Review your benefits handbook or contact your insurance carrier directly for complete details.

My insurance requires a copayment. Am I required to pay the copayment when I arrive for my appointment?

Yes. Copayments will be collected when you check in for your appointment. We accept cash, check, or credit/debit card.

How will I know how much I owe?

You will receive a statement if there is a balance due after your insurance company processes your claim(s).​

You may be required by your insurance company to make a copayment at the time of service. Check with insurance and ask if you are responsible for copayments.

I provided my insurance information to the hospital while I was a patient there. Did you receive that information from the hospital?

Marshfield Clinic and the hospital are separate entities and do not provide patient’s insurance information to each other. Please contact our insurance department at 1-800-782-8581at extension 75559 to report your insurance information.

Can you offer me a discount in addition to my insurance company’s discount?

Marshfield Clinic honors the terms of your insurance company’s contract which does not allow for an additional discount.

Will you bill my secondary insurance provider?​

Yes, Bring a copy of your insurance benefit cards to your next appointment and present it during check-in at the appointment desk. We submit claims to your secondary insurance along with an explanation of benefits from your primary insurance after they've processed your claims and sent remittance to Marshfield Clinic. 

Out of network

Your insurance may not have an agreement with Marshfield Clinic. Check our listing of Contracted Insurance Plans for more details. ​

You may still choose Marshfield Clinic for out of network services. If you choose to receive "out-of-network", non-emergency care, your insurance company may expect you to pay larger out of pocket costs. It may be helpful for you to to call your insurance company and review your plan's "out-of-network" options.​

What if I don’t have health insurance?

Please contact our Patient Assistance Center​ at 1-800-782-8581, extension 94475. They may be able to assist you with enrolling in the Marketplace or locating resources to help with medical bills.

I don’t have health insurance. Is there a discount for uninsured patients?

Marshfield Clinic offers a 5% discount to uninsured patients.

Uninsured or underinsured​

​Most people under the age of 65 are required to get health insurance through their employer, through Medicaid or through the Health Insurance Marketplace​.

If you do not have insurance and want to see a Marshfield Clinic provider we do offer a 5% discount.

What happens when an account member turns 18?

When a person becomes 18 years of age, they are considered an adult and entitled to privacy protection.  

Why can’t I be placed on the same account as my spouse?

Because of increased privacy regulation, adult patients are assigned to their own accounts.  This provides a greater degree of privacy and allows patients more control over their account information.  ​

It will be helpful to complete a HIPAA Authorization form. The form allows us to discuss your account with a person you designate when you are not available to speak with us. The form can be found online at: Patient Forms