My goal with this blog is to enable you and your family to make the best choices you can about how you live your life in relation to your health.
The decisions we make, large and small, throughout our lifetimes play an important role in our overall health, and I hope to encourage positive changes that may help improve the lives of my patients and readers.
I believe the philosophies of both Western and alternative therapies can work together to aid the healing process. I’ll provide you with evidence-based medicine to help you make informed decisions on therapies you may be using at home, or may be contemplating adding to your wellness routine.
Teton Valley is a great place for growing and healing. I enjoy the outdoor activities our area has to offer, including rock climbing, backcountry skiing and hiking. My husband, Jansen, and our Great Pyrenees mix, Kingsley, especially love the long winters and powder days.
I’m excited for my 7-month-old girl, Saraya, to grow up in Teton Valley. I’ve lived here for two years, after spending six years in Jackson, Wyo. I love the peacefulness of the valley and the strong, lively community of which we are a part.
Disclaimer This blog is meant for educational purposes only and should not be considered direct medical advice. Consult your provider before beginning any activities or programs. Anna Gunderson, PA-C is a nationally certified Physician Assistant. She sees patients at the Driggs and Victor Health Clinics. For more information or to make an appointment, call (208) 354-2302.
Helping kids to smile all over the world, local resident and pediatric nurse practitioner Heather Bagley knows a few things about rural third world hospitals. Thirteen years ago Bagley went to Nicaragua on behalf of the organization Operation Smile, as one of several professionals volunteering to help repair cleft lip, cleft palate and other facial deformities.
When it comes to making improvements in our billing process, our most valuable resources are our patients and their families. Concerns, complaints and suggestions from our patients have led to changes throughout our entire business cycle including changes in our processes, staff training, and software changes. We get patient complaints for less than one percent of all bills we send out, but we know that doesn’t help if you are the one with a billing issue.
If at any time you or someone you know has a question about their Teton Valley Health Care bill, please be sure to give us a call or send an email or letter requesting assistance. While it may feel therapeutic to turn to your neighbors or Facebook friends, we appreciate direct communication otherwise we won’t know about the problem and can’t fix or answer the concern.
Here’s an overview of how our billing cycle works, along with definitions of different billing terms.
When we send the first statement after a patient visit, it’s a detailed list of services. Every statement thereafter is a summary of the balance remaining, not a detailed list. We believe this provides patients with necessary data, but it doesn’t overwhelm patients by repeating the same details multiple times. If you ever need a detail for any of your visits, we’re happy to provide that for you along with any assistance in understanding the details.
We don’t send a statement for a service until the claim has been processed by the patient’s insurance. This helps to ensure that a patient is only billed for the amount they owe TVHC and that any insurance issues (eligibility, deductibles, and coverage terms) are dealt with before we ask you for payment. We do everything we can to provide a correct claim to your insurer immediately after the care is rendered. We want to see the insurer quickly and correctly process the claim as much as the patient does. If we’ve received incorrect billing information (this is why we always ask for your insurance information when you check in), if the insurance doesn’t process the claim correctly, if the insurance company needs additional information such as accident verification data, or if there are any other problems with the claim, it can take several months for the insurer to process and pay for the claim.
You’ll know when your insurance has processed your claim when you receive an Explanation of Benefits (EOB) that shows what you may still owe after your insurance has paid for any covered services. If you disagree with your EOB, you should contact your insurance provider for clarification. Most claims (bills) are sent to the insurance company and processed by the insurance company within 3 weeks of the date of service, so you should expect a TVHC bill 3-4 weeks after your visit.
Once the patient’s claim is processed by the insurer, or if the patient is uninsured, we send out the first statement with a list outlining the provided services. We then call each guarantor (the person listed as responsible for payment) within two weeks of that first statement to ensure that the statement was received, that it’s correct, and to see if there are any questions regarding the statement. This is not a “collections call”; it’s a courtesy call from our billing office offering to help you with any questions about your bill. If the statement is received and correct, we offer to accept payment immediately (we do accept most major credit cards).
We continue to reach out to the guarantor by phone and in writing (at least monthly) until the balance is paid or a payment plan is established. We work with patients who are unable to pay their bill by offering payment plans, assistance in applying for insurance, or through our financial assistance program. However, if a patient or guarantor doesn’t respond to our letters or calls, or fails to make necessary payment, we refer the person to a collection agency after 120 days. This is an action of last resort.
In addition to your hospital or clinic statement, you may also receive statements from other providers such as radiologists and pathologists. Multiple statements and potentially multiple explanations of benefits from insurance companies can complicate the process.
We want our patients and their families to be as satisfied as possible with our care and we’re available to help you navigate the statements, instructions and explanations that you may receive. We want to hear from you.