Billing and Insurance Information
Notice of Financial Responsibility
You are responsible for the cost of your medical care when you come to our clinics. While our team will submit claims to your insurance provider, any remaining balance—including co-pays, deductibles, or non-covered services by your insurance—will be your responsibility. This may include services such as physical therapy, lab work, and ultrasounds ordered by your provider to ensure the best possible care.
If you have questions about billing or payment options, please refer to our financial policies or speak with our front desk staff when you check in.
Insurance
We accept a wide range of health plans. We encourage you to touch base with your insurance plan about coverage for your care with a Premier Women’s Health of Minnesota provider.
You can provide them with our National Provider ID (NPI) 1801946223 to verify if we are in your network.
Please be sure to bring a copy of your insurance card information or an and a form of payment to your appointment. Co-pays and deductibles are determined by your insurance plan and are due at the time of service.
Insurances we accept:
- MN-Aetna
- MN-Americas PPO
- MN-BCBS of MN
- MN-Cigna
- MN-HealthPartners
- MN-Hennepin Health
- MN-Humana
- MN-Medica
- MN-Medicaid
- MN-Medicare
- MN-Multiplan
- MN-Surest
- MN-Tricare
- MN-UCare
- MN-UHC
- MN – UMR
- MN-VA CCN
Online Bill Pay
Secure and convenient: we accept online payments.
Pay By Mail
Patient Payment Address
Premier Women’s Health of Minnesota
PO Box 14099
Belfast, ME 04915
Business Office Contact Information
If you have a question about payment or any other billing inquiries, please call the business office at 651-461-8866.
Business Office Address
Premier Women’s Health of Minnesota
PO Box 81068
Cleveland, OH 44181
Service Pricing Transparency
The State of Minnesota requires our practice to post provider charges for common services, and the average payments or reimbursements received for those services from government and commercial insurance.
Coding for Services
All healthcare providers bill services using CPT billing codes. These codes tell the insurance company what was done and why. Routine and preventive services cause confusion for many patients. It is not uncommon for patients in the course of a visit to receive both treatment for a problem and a preventive service. When this occurs, we are required to charge for both services.
Lab Services
The majority of our lab services are processed and billed by a reference lab. Billing is based on your insurance plan guidelines. The reference lab is not owned by Premier Women’s Health of Minnesota and will send a separate bill.
Frequently Asked Questions
Laboratory Services
If you have insurance, your laboratory services are billed to your plan. Coverage depends on your specific benefits and may include full payment, application to your deductible, co-insurance, or denial if the service is not covered.
In some cases, labs may be denied as not medically necessary based on your insurance policy. Your provider orders labs based on what is medically appropriate for your care. We recommend
contacting your insurance company before your visit to better understand your coverage. If you do not have insurance, a 20% discount will be applied to your balance.
The 21st Century Cures Act requires healthcare organizations to release test results to patients as soon as they are finalized. Because of this, you may see your results in the patient portal before your provider has reviewed them.
Your provider will follow up with you as soon as possible. We encourage you to use the Athena Health patient portal to access results and communicate with your care team.
Preventive vs. Diagnostic Care
The coding of your visit is based on your provider’s documentation and the reason for your visit. If you are experiencing symptoms or receiving treatment for a specific concern, services are billed as diagnostic rather than preventive.
We cannot change coding if it does not accurately reflect your visit, as this would not comply with billing regulations.
Preventive visits are designed for routine screenings when no specific concerns are addressed. If additional concerns, symptoms, or conditions are discussed or evaluated during your visit, those services may be billed separately as a problem-focused (diagnostic) visit. This can result in additional charges, such as office visit fees, labs, or procedures.
We recommend checking with your insurance provider prior to your visit to understand your benefits. Payment for services is ultimately the patient’s responsibility.
Ultrasound Billing
The provider listed on your bill is the one who reviewed and officially interpreted your ultrasound. This may differ from the provider you saw during your appointment.
Ultrasounds are typically performed for diagnostic purposes, meaning they evaluate symptoms or a medical concern. Diagnostic services are subject to your deductible, co-pay, and/or co-insurance.
In some cases, both transabdominal and transvaginal ultrasounds are required to fully assess your condition. These are billed as two separate procedures.
Additional Services & Charges
Effective January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) approved CPT Code 99459. This is a practice expense add-on code that helps cover the additional resources required to perform pelvic exams. Commercial insurance plans may not cover this code, and if not covered, the cost may be your responsibility.
As part of our commitment to comprehensive care, we perform mental health screenings during certain visits using tools such as the MDQ, PHQ-2, PHQ-9, and GAD-7.
These screenings are billable services (CPT 96127 or G0444) and are submitted to your insurance. Depending on your plan, this may result in a co-pay or be applied to your deductible or co-insurance.
Procedures
Most procedures, including colposcopies and endometrial biopsies, are considered diagnostic rather than preventive. Diagnostic services are typically subject to your deductible, co-insurance, and/or co-pay, which may result in a patient balance.