Paying Your Bill Online: when paying your bill online, please make sure that you are going directly to the Missoula Bone & Joint Online Bill Pay Option. If you pay via a different link, for example doxo.com you will be charged a service fee (they are a third party company with no affiliation to us). Missoula Bone & Joint does not charge a service fee to process online payments. If you have questions about paying your bill, please call our billing department directly, for CLINIC: (406) 532-8065 and for SURGERY CENTER: (406) 829-5582
Insurance: At Missoula Bone & Joint, we are preferred providers with many insurance companies, including workers’ compensation and Medicare. Please contact your insurance company to verify eligibility and coverage. The following is a list of insurances that we are contracted with as well as preferred provider organizations (PPOs):
This list changes from time to time so please call your insurance company before your visit or give us a call (406) 532-8779.
- Allegiance & Cigna Allegiance
- Blue Cross (Traditional, FEP, HMK, Medicare Advantage PPO and HMO, HELP, Blue Focus, Blue Options)
- Medicare **
- Missoula County Benefits
- Montana Health Co-op
- Pacific Source
- Pacific Steel
- Railroad Medicare
- Tribal Health
- Tricare West Region
- VA Triwest
- Allegience PPO
- First Choice PPO
- Health InfoNet PPO
- Interwest PPO
- Multiplan PPO
- Western Integrated Care
* We are NOT contracted with Humana Gold, a Medicare HMO, because of the pre-authorization requirement by your primary care physician for every service item which causes treatment delays as well as non-payment of services. We are sorry for any inconvenience this causes you. We are contracted with BCBS Medicare Advantage and regular Medicare.
**We are NOT contracted with AETNA, Cigna, Corvel/Corecare, First Health/Coventry, HEHA, Integrated Health, Medicaid of Idaho, New West Medicare, OWCP, PPO USA, Preferred Medical Claim Solutions, Rockport, Three Rivers Pro. Net, Sterling Medicare Select, Tricare (West Region), United Healthcare, Champ VA.
Insurance Information for Veterans:
We do accept and bill to VA Triwest, Tricare, and Tricare for Life. We can help you navigate the system to get you the care you need. If you have questions please call our insurance department at (406) 532-8779. We are not contracted with Champ VA.
Insurance Information for Urgent Care Patients:
Missoula Bone & Joint is not a free-standing Urgent Care facility. We are required to bill your urgent care visit to your insurance company as an "Office" visit instead of an "Urgent Care" visit. What this means is that your insurance company may pay the benefits differently if billed under "Office" versus "Urgent Care" and your out-of-pocket expense may differ.
Attention Patients with Missoula County Benefits:
If you have a NEW injury and are being treated through Urgent Care, you are responsible for a $15 co-pay at your initial visit. The first set of x-rays are covered at 100% but you will be responsible for any deductible or co-insurance amounts for additional services provided (i.e DME, casting, injections). In addition, you will be responsible for any deductible or co-insurance amounts for any subsequent visits.
Payment: If your insurance plan requires you to pay a co-payment, co-insurance, and/or a deductible, you will need to pay at the time of your visit. For your convenience we accept cash, checks, Visa, MasterCard, Discover, and American Express. If you need to speak to us with regards to payment please call our Billing/Insurance department: for a question related to your bill or insurance, please call our billing specialists at (406) 532-8779. To pay a bill call (406) 532-8065.
Surgery Billing: If surgery is required, separate statements will be sent to you for each provider of services. You may receive billing from each of the following:
- Physician
- Surgery Center or Hospital
- Surgical Assistant
- Anesthesiologist
- Pathology/Lab
- Durable Medical Equipment (DME) Providers
Workers’ Comp: You are required to provide the following information upon scheduling your appointment:
- Work comp carrier and address
- Date of injury
- Claim number
- Employer at time of accident
- Adjustor and contact number
This information will ensure accurate and timely filing of your claims. Without this information we will be unable to submit your claim to your work comp carrier and, therefore, will ask for payment at time of service.
If your claim is denied or not paid within a timely manner, we request that you file a personal claim with your health insurance and pay the charges in full. We recommend you notify your employer should there be any delays in settling your workers’ compensation claim.
Billing Questions: If you have a question related to your bill or insurance, please contact our billing specialists at (406) 532-8779. To pay a CLINIC bill, call (406) 532-8065, To pay a SURGERY bill call (406) 829-5582 or you may pay your bill online.
No Surprises Act
No Surprises: Understand your rights against surprise medical bills
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
Starting in 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights.
What are surprise medical bills?
Before the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, even unknowingly, your health plan may not have covered the entire out of-network cost. This could have left you with higher costs than if you got care from an in-network provider or facility. In addition to any out-of-network cost sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill. People with Medicare and Medicaid already enjoy these protections and are not at risk for surprise billing.
What are the new protections if I have health insurance?
If you get health coverage through your employer, a Health Insurance Marketplace®,1 or an individual health insurance plan you purchase directly from an insurance company, these new rules will:
• Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization). • Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services. • Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility. • Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider).
What if I don’t have health insurance or choose to pay for care on my own without using my health insurance (also known as “self-paying”)?
If you don’t have insurance or you self-pay for care, in most cases, these new rules make sure you can get a good faith estimate of how much your care will cost before your receive it.
What if I’m charged more than my good faith estimate?
For services provided in 2022, you can dispute a medical bill if your final charges are at least $400 higher than your good faith estimate and you file a dispute claim within 120 days of the date on your bill.
What if I do not have insurance from an employer, a Marketplace, or an individual plan? Do these new protections apply to me?
Some health insurance coverage programs already have protections against surprise medical bills. If you have coverage through Medicare, Medicaid, TRICARE, or receive care through the Indian Health Services or Veterans Health Administration, you don’t need to worry because you’re already protected against surprise medical bills from providers and facilities that participate in these programs.
What if my state has a surprise billing law?
The No Surprises Act supplements state surprise billing laws, it does not supplant them. The No Surprises Act instead creates a “floor” for consumer protections against surprise bills from out-of-network providers and related cost-sharing responsibility for patients. So as a general matter, as long as a state’s surprise billing law provides at least the same level of consumer protections against surprise bills and higher cost-sharing as does the No Surprises Act and its implementing regulations, the state law general will apply. For example, if your state operates its own patient-provider dispute resolution process that determines appropriate payment rates for self-pay consumers and Health and Human Services (HHS) has determined that the state’s process meets or exceeds the minimum requirements under the federal patient-provider dispute resolution process, then HHS will defer to the state process and would not accept such disputes in the Federal process.
As another example, if your state has an All-Payer Model Agreement or another state law that determines payment amounts to out-of-network providers and facilities for a service, the All-Payer Model Agreement or other state law will generally determine your cost-sharing amount and the out-of-network payment rate.
Where can I learn more?
Still have questions? Visit https://www.cms.gov/nosurprises, or call the Help Desk at 1-800-985-3059 for more information. TTY users can call 1-800-985-3059.
1Health Insurance Marketplace® is a registered service mark of the US Department of Health & Human Services