Billing and Insurance
Managing the financial matters related to your health can be stressful. Understanding your insurance plan and your financial responsibilities before you arrive at Maricopa Integrated Health System (MIHS) will make getting the care you need much easier and less hectic.
We are here to help you by working with your insurance provider and answering any questions you may have.
Plans are changing in 2017
You can select MIHS as your healthcare provider. Most individuals can get financial help with premiums and out-of-pocket costs. Consider selecting either Ambetter Balanced Care Silver Plan 4 or 9 so you can receive cost sharing assistance. When you sign up by December 15th - you’ll receive quality healthcare from MIHS that begins January 1st.
Get FREE assistance and answers to all of your questions at: 1-602-344-2550 Monday - Friday 7:30am - 5:00pm or email us at ACA@mihs.org. For more information on how to enroll visit Ambetter Health Net.
What are my financial responsibilities?
Although your health insurance plan may cover services at MIHS, you may still be required to make a payment at the time of your visit. You can pay with cash, a check or a credit card. The amount will vary depending on your plan. We can help you understand your health insurance, including co-pays, co-insurance and deductibles.
What can I do to manage these responsibilities?
It is important that you provide MIHS with your family’s most up-to-date health insurance information. You should also understand your plan, its benefits and its requirements. Please ask your insurance plan provider and MIHS's insurance specialists any questions you have — we're here to help you.
Financial Assistance Program
At MIHS, we know seeking medical care can be overwhelming. That's why we have developed a program to help you deal with the financial stress of paying for the healthcare you deserve.
Our dedicated team will help you understand the benefits to which you are entitled and, if eligible, assist you in applying for AHCCCS coverage. If you cannot afford to pay your bill after all payers have processed your claim(s), we will help you apply for financial assistance from Maricopa Integrated Health System. We will advise you of the documentation required to receive financial assistance.
Key facts about MIHS' Financial Assistance Program:
- Maricopa Integrated Health System has professionals ready to walk you through the AHCCCS application process. Call the Family Health Clinic nearest you and ask for an Eligibility Specialist to begin the application process.
- A sliding fee scale will be used to determine the percentage you will pay of your bill.
Financial Assistance Program at a glance:
- You must apply for AHCCCS coverage and be denied to participate in the Financial Assistance Program.
- The Financial Assistance Program uses a sliding fee scale that determines what you pay based on your income level and household size.
- Maricopa Integrated Health System can help you even if you are uninsured or underinsured. We are your community healthcare system and we will work with you to prove it.
What you need to bring with you to your appointment:
- Identification: Current I.D. or birth certificate for every person in household as well as Social Security cards.
- Proof of Income: Information that verifies income for at least the last 30 days. If not received any income in the last 30 days, a statement from the person(s) providing financial support is required.
- Proof of Address: Document verifying Maricopa County residency. Can be a: recent utility bill, rent/mortgage receipt, voter registration card or a letter from a non-related landlord or neighbor.
- Citizenship or immigration documents.
Understanding Your Health Insurance
There are hundreds of health insurance plans, and each one is different. Before scheduling services at MIHS, you should:
Review the list of payors (insurance companies) with which we participate. Please visit "Does MIHS Take My Insurance?" If your plan doesn't appear on this list, call your insurance company to ask if they consider MIHS to be "in-network."
Find out if your plan requires a referral or authorization. Before your visit, you will need to call your insurance company for specific plan-related questions, such as the MIHS-provided services that require referral or authorization. Your visit may be canceled or rescheduled if authorization is not approved by your insurance company. If your insurance company needs a referral and/or pre-authorization, please call your primary care doctor before scheduling an appointment with us.
Learn more about the charge for your visit to MIHS. Call our Customer Service at 602-344-8181 if you are coming in for outpatient visits. Ask what the fee for the physician office visit may be. We cannot always determine in advance what services you will require and receive so we may not be able to provide a complete estimate of cost in advance.
If you are admitted for an inpatient visit, you will be charged for:
- The physicians’ time spent examining
- Any procedures/tests that are performed
- Hospital services including nursing care, supplies, machines, equipment and the use of the Hospital’s facilities
Find out about the services covered by your insurance plan. Most insurance plans make you pay for your part of the service provided to you through a “co-pay,” “deductible” and/or “co-insurance.” Your plan may also pay differently for certain MIHS services (such as labs and radiology) or certain MIHS locations, which may affect your financial responsibility. All of these amounts are set by your insurance plan. Please call your insurance company directly for more information.
Be prepared to pay your co-pay or co-insurance at the time of your visit. MIHS accepts payment in the form of cash, credit cards and checks. If our staff is unable to collect your physician and/or hospital co-pay at the time of your visit, you will be billed separately for the applicable co-pay(s).
Does MIHS Take My Insurance
MIHS and its affiliated physician group have agreements with the list of insurance plans provided in the list on this page. Each of these agreements is different, covering varying levels of healthcare services provided by the Hospital.
Some of the insurance plans listed below cover the full scope of services provided by the Hospital and its affiliated physician groups. Others cover a smaller selection of services. If you are not sure what healthcare services are provided by your insurance plan, please contact your insurance provider to find out what is covered or call our Customer Service at 602-344-8181 for additional information.
Ambetter (Limited or select plan participation) (A Health Net Marketplace product)
Arizona Foundation for Medical Care
Blue Cross Blue Shield of Arizona (HMO, PPO, Indemnity) (Excludes Marketplace)
Blue Cross Blue Shield (Non-Arizona)
Bridgeway Health Solutions (ALTCS)
Care 1st (AHCCCS)
CIGNA (Behavioral Health)
CIGNA (Great West Life-GWL)
CIGNA (Healthcare of AZ)
CIGNA HealthSpring (Excludes Primary Medicine)
Gila River Healthcare (AHCCCS)
Gila River Healthcare CORP (TRBHA)
Health Choice Advantage (Medicare)
Health Choice Arizona (AHCCCS)
Health Net of Arizona (AHCCCS)
Health Net Commercial
Health Net Medicare
Mercy Care Advantage (Medicare)
Mercy Care Plan (AHCCCS)
Mercy Maricopa Integrated Care (AHCCCS)
United Healthcare Commercial
United HealthCare Community Plan (Formerly APIPA)
United HealthCare Community Plan CRS
United HealthCare Community Plan LTC DD (Formerly Evercare LTC)
United HealthCare Dual Complete (APIPA, Medicare)
United Tricare (UHC Military and Veterans Services)
University Family Care (AHCCCS)
Understanding Your Bill
Even if your insurance plan covers your visit to MIHS, you are still responsible for any cost-sharing expense, such as co-pays, co-insurance and deductibles. The amount will vary depending on your insurance and will be found in your bill.
In order to comply with Centers for Medicare and Medicaid Services and insurance industry regulations, Maricopa Integrated Health System bills for both facility and professional services. So when you visit MIHS or one of our clinic sites, you may receive more than one bill. The bill you receive from MIHS is for use of our facility (facility charges). The physicians, radiologists and other specialists may bill you separately from their own practices (professional fees). We all work together to provide you with excellent care.
Facility bill (Hospital or Clinic)
A facility charge covers the cost of running the facility (hospital or clinic). This includes supplies, equipment, radiology, laboratory services, exam rooms, non-physician staff, and other costs of running a facility that provides the highest level of patient care. The facility charge varies based on whether you are a new or established patient, the type of visit, and the hospital resources required to effectively treat you.
Maricopa Integrated Health System’s specialty centers are licensed by the State of Arizona as hospital-based clinics. These centers are part of the Maricopa Integrated Health System’s facility, with the same services and amenities provided at the main campus. Thus they incur the same facility charge as a visit to the main campus. This is a standard practice for most other hospital-based clinics across the country.
Questions about your Hospital bill? Call 602-344-8181
The bill you receive from the physician is for professional services such as evaluation and management and procedures performed by physicians and other clinicians who were involved in your care. This includes providers at MIHS’s Main Campus and all Primary Care and Specialty Care locations.
Questions about your Physician bill? Call 602-344-8181
If you have received an explanation of benefits (EOB) from your insurance carrier but have not received your Hospital bill and Physician bill within 90 days of receiving the EOB, please contact us at 602-344-8181