Can anyone go to Cleveland Clinic?

Cleveland Clinic does not require a referral, however your insurance company might require one to provide coverage for your visit or procedure. For more details, please review our billing checklist.

my.clevelandclinic.org - Insurance FAQ | Cleveland Clinic

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Does Cleveland Clinic accept Medicare?

Yes and most Medicare patients will be covered through Medicare and their supplemental insurance. Medicare patients without supplemental insurance can expect to have a balance.

Does Cleveland Clinic require a referral from an outside doctor?

Cleveland Clinic does not require a referral, however your insurance company might require one to provide coverage for your visit or procedure. For more details, please review our billing checklist.

How can I get an appointment if I have no insurance or a plan not accepted by Cleveland Clinic?

We will provide you with a Financial Review.

How do I know if Cleveland Clinic contracts with my health plan?

To receive full insurance benefits, some insurance providers require patients to receive services with “in-network” or “participating provider” hospitals and physicians. Call your insurance provider to make sure Cleveland Clinic is in your network.

If Cleveland Clinic is “out of network,” may I still go there?

Yes. In an emergency, always go to the closest hospital. Your insurance provider generally will cover emergency department costs or transfer you to an “in-network” hospital if it is safe to do so. If you choose to go to an “out-of-network” hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Call your insurance company to find out your health plan's “out-of-network” options.

How can I be sure my insurance provider will pay my bills?

Your health plan may:

Require certain services to be authorized, or pre-certified, before you receive them

Require you to notify them within a certain period of time after services are rendered Find out your health plan's requirements by reading the information given to you by your insurance provider or employer, or by calling your insurance provider directly. You also may call a Cleveland Clinic billing representative to discuss insurance payment concerns at 216.445.6249 or 866.621.6385 (toll-free).

Does Cleveland Clinic send the necessary information and paperwork to insurance providers?

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Yes. However, they sometimes need more information from you to process a claim. If you’re unsure, you can contact your provider to make sure they have what they need. You can also contact the Cleveland Clinic billing representative with questions at 216.445.6249 or 866.621.6385 (toll free).

How will I know how much I owe?

Your health plan may require a co-payment or deductible that will be due during appointment registration or hospital discharge. Check with your insurance provider on the amount that you will be responsible for at this time. Following your healthcare services, your insurance provider will send you an Explanation of Benefits (EOB), which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Cleveland Clinic. Review this EOB, compare it to your Cleveland Clinic billing statement, and call your insurance provider or a Cleveland Clinic billing representative if you have questions or concerns.

Does Cleveland Clinic bill secondary insurances?

Yes, Cleveland Clinic is dedicated to helping you receive full benefits from your insurance provider. You will be asked to provide complete insurance information upon registration. Be sure you have a copy of your insurance cards at that time. As a service to you, we will submit secondary claims along with required EOBs to your insurance provider. However, if your insurance provider doesn't make payment within 60 days, we will ask you to pay the amount owed.

What if I don't have health insurance?

Emergency service will never be delayed or withheld on the basis of a patient's ability to pay.

For general care, if you do not have health insurance, call:

Patient Financial Services Department

Phone: 216.445.6249

866.621.6385 (toll-free)

The billing representative will review payment and financial assistance options that may be available to you.

my.clevelandclinic.org - Insurance FAQ | Cleveland Clinic

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