Billing and Payments

At Franklin County Medical Center, we want to make it easy for you to understand and handle your payments. Below you will find all the information you need about what to expect when it comes to paying for your medical services.

Take your time to explore this page and make sure you have a clear understanding of how billing works. If you have any questions or worries, our staff is here to help you.

Payment Due at the Time of Service / Registration

At Franklin County Medical Center, we ask for payment before you receive medical treatment, just like many other businesses do.

This payment includes different types of fees that you may have to pay. Here’s what you need to know:

Payment Types:

  • We accept: cash, checks, debit cards, credit cards, care credit, and money orders
  • We accept: American Express, Discover, MasterCard, and Visa credit cards

Types of Fees:

  • Co-payments: This is a fixed amount of money that you need to pay each time you visit the medical center.
  • Co-insurance: This is a percentage of the total cost of your medical services that you are responsible for paying.
  • Deductibles: This is the amount of money you need to pay before your insurance coverage starts.
  • Services Not Covered by Insurance: Some medical services may not be covered by your insurance program, and you will be responsible for paying for them.

Health Insurance

At Franklin County Medical Center (FCMC), we accept most insurance plans. We want to make things easier for our patients, so we will take care of filing a claim directly with your insurance company. Here are the important points to remember:

Insurance Process:

  • FCMC will file the insurance claim on your behalf.
  • Our Business Office will follow up on the claim payment status.
  • If we don’t receive payment from your insurance provider within a reasonable time, we will bill you for the services.

Contacting Business Office:

  • If you have any questions or concerns about insurance payments or the statements you receive in the mail, please reach out to our Business Office at 208-852-0137.

Verifying Insurance Coverage:

  • Before your first appointment, we kindly ask you to call your insurance company and verify if FCMC and your doctor are in-network. This will help ensure smooth insurance coverage.

What if I forget to bring my insurance information to the appointment?

If you forget to bring your insurance card when you come to Franklin County Medical Center, you will be registered as a “private pay” patient.

This means that you are responsible for paying the full bill. We ask all patients to bring their Insurance Cards each time they visit.

Private Pay

If you don’t have health insurance, you will be considered a private pay account at our medical center. As a private pay account, you need to pay for your services at the time of your visit.

If you don’t have the exact amount to pay, we will ask for a deposit. The deposit amount may vary depending on the type of service you receive.

Emergency Room Billing

When you go to the Emergency Room (ER), a nurse will evaluate all patients. They will determine the order in which patients are seen based on their symptoms and vital signs.

Vital signs include blood pressure, temperature, respiration, and oxygen levels if needed. Here’s what you need to know:

  • The nurse’s assessment is a professional service for which all patients are billed.
  • Wait times can differ based on the number of patients and the severity of their medical conditions.
  • You are required to make a co-payment when you receive ER services.

Auto/Workers’ Comp Insurance

When you come to Franklin County Medical Center (FCMC), it’s important to let us know if your visit is due to a car accident or a work injury.

Here’s what you need to know:

  • Please inform us on the day of your visit if your condition is a result of an auto accident or work injury.
  • We will reach out to the appropriate party to obtain a claim number for your case.
  • For these types of visits, your health insurance will not be billed as the primary payer.
  • In order to request payment from your health insurance carrier, we need a letter from the primary payer stating that all funds have been exhausted or denied.

It’s crucial to provide us with accurate information about the accident or work injury to ensure proper handling of your claim.

Additionally, if you do not provide employer information, you will be responsible for the bill.

Our team is here to assist you, so please make sure to communicate these details during your visit.

Patient Price Information List

Franklin County Medical Center uses a special system called Chargemaster to decide how much to charge for things patients need. This system has a list of charges for all the things the hospital gives to patients.

These charges are the starting prices for everything. If you want more details, you can check the Patient Price Information List.

No Surprise Act / Good Faith Estimate

You have the right to receive a document called a “Good Faith Estimate” that tells you how much your medical care will cost. The law says that if you don’t have insurance or if you’re not using insurance, healthcare providers have to give you an estimate of how much your medical items and services will cost.

Here are some important things to know:

  • You can ask for a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes things like medical tests, prescription drugs, equipment, and hospital fees.
  • Your healthcare provider should give you the Good Faith Estimate in writing at least 1 business day before your medical appointment or procedure. You can also ask for the estimate before you schedule anything.
  • If you get a bill that is $400 or more than your Good Faith Estimate, you can challenge the bill.
  • It’s a good idea to keep a copy or take a picture of your Good Faith Estimate.
  • If you have questions or want more information about your right to a Good Faith Estimate, you can visit cms.gov/nosurprises or call (800) 985-3059.

Your Rights and Protections Against Surprise Medical Bills

You have rights and protections to help you avoid surprise bills when you receive emergency care or get treated by a doctor who is not in your insurance network at a hospital or surgical center that is in-network.

What is Balance Billing (Surprise Billing)?

When you go to a doctor or another healthcare provider, you might have to pay some costs out of your own pocket, like a copayment, coinsurance, or a deductible. If you go to a provider or visit a healthcare facility that is not in your health plan’s network, you might need to pay extra costs or the entire bill.

If you visit a provider or a healthcare facility that is not part of your health plan’s network:

  • They are considered “out-of-network” providers.
  • Out-of-network providers can charge you for the difference between what your plan agreed to pay and the total cost of the service. This is called “balance billing.”
  • The amount you are charged through balance billing is usually more than what you would pay for the same service with an in-network provider.
  • The charges from balance billing may not count toward your yearly out-of-pocket limit.

“Surprise billing” occurs when you receive an unexpected balance bill. This can happen in situations where you have no control over who is involved in your care, such as during an emergency or when you schedule a visit at a facility that is in-network but end up being treated by an out-of-network provider without expecting it.

You are Protected From Balance Billing in the following situations:

  • Emergency Situations
    If you have a medical emergency and receive emergency services from a provider or facility that is not in your network, they can only charge you the same amount as if you went to an in-network provider. They are not allowed to charge you extra for these emergency services. This rule applies even if you continue receiving services after your condition becomes stable unless you agree in writing to be billed for those additional services.
  • Services at an In-Network Hospital or Surgical Center
    When you go to a hospital or ambulatory surgical center that is in your network, some of the providers there may not be in your network. However, in such cases, those providers can only charge you the same amount as if they were in your network. This rule applies to specific services like emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers are not allowed to charge you extra or ask you to give up your protection against balance billing.If you receive other services at these in-network facilities from out-of-network providers, they are not allowed to charge you extra either, unless you agree in writing to be billed for those services and give up your protection against balance billing.You never have to give up your protection against balance billing. You also don’t have to get care from providers or facilities that are not in your network. You can choose a provider or facility that is in your plan’s network.
  • Protections When Balance Billing Isn’t Allowed
    You only have to pay your share of the cost, like copayments, coinsurance, and deductibles, just as you would if the provider or facility was in your network.Your health plan will directly pay out-of-network providers and facilities.

Your health plan must:

  • Cover emergency services without needing approval beforehand (prior authorization).
  • Cover emergency services provided by out-of-network providers.
  • Calculate what you owe the provider or facility based on what it would pay an in-network provider or facility, and show that amount in the explanation of benefits.
  • Count any money you pay for emergency services or out-of-network services towards your deductible and the total amount you have to pay out of your own pocket.
  • If You Believe You’ve Been Wrongly Billed
    Please contact us with any questions you have. You may also contact the Idaho Department of Insurance by visiting the department’s website at doi.idaho.gov/nosurprises or calling the Consumer Affairs section at 1-208-334-4319 or toll-free in Idaho at 1-800-721-3272.Visit doi.idaho.gov/nosurprises for more information about your rights under this law.