Billing FAQ

 Who do I call with questions about my Affinity bill?

For billing or insurance questions

Clinic Bill 844.846.2438

Hospital Bill 866.832.1120

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 I misplaced by billing statement (or return envelope). Where should I send my payment?

If your bill came from Affinity Medical Group, please mail payment to:
Affinity Medical Group
ATTN #848583E
P O Box 14000
Belfast ME 04915-4033

If your bill came from Affinity Behavioral Health, please mail payment to:
Affinity Behavioral Health Medical Group
ATTN #848583E
P O Box 14000
Belfast ME 04915-4033

If your bill came from Mercy Medical Center, please mail payment to:
Mercy Medical Center of Oshkosh Inc.
P.O. Box 856968
Minneapolis, MN 55485-6968

If your bill came from St. Elizabeth Hospital, please mail payment to:
St. Elizabeth Hospital Inc.
P.O. Box 856960
Minneapolis, MN 55485-6960

If your bill came from Calumet Medical Center, please mail payment to:
Calumet Medical Center Inc.
P.O. Box 856902
Minneapolis, MN 55485-6902

If you know your account number, please write it on your check.  This ensures your payment is promptly applied to your account.  If you do not know your account number, please call the Affinity Health System Customer Service department before mailing your payment, and they will be happy to provide your account number. 

Clinic Bill 844.846.2438
Hospital Bill 866.832.1120

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 Can I pay my bill online?

Yes, patients have the ability to quickly make a payment securely online. At the top of the Affinity home page, you will now see the option, "QuickPay". In order to use this feature, it will be necessary for you to enter your code from your paper statement.

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 What if I am unable to pay my entire balance today?

We understand that medical bills are sometimes unexpected, which can strain family budgets. For your convenience, Affinity accepts debit cards and credit cards, including MasterCard, Visa, Discover and American Express.

Affinity also offers credit representatives who can help you make payment arrangements when you are not able to pay your entire bill. Our credit representatives will be glad to discuss the following:

  • Interest-Free Financing
    This plan allows patients to make monthly payments on their bill. For balances of $150 or less, we require a minimum monthly payment of $25.
  • Extended Payment Plan
    This plan extends the payment period at a preferred interest rate, through an outside billing service.
  • Financial Assistance Program (FAP)

Credit representatives are available from 8 a.m. to 4:30 p.m., Monday through Friday, at 1-866-832-1120 (Select option 1) to establish payment arrangements or to discuss financial assistance.

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 Does Affinity Health System provide free care to those in need? (What if I'm unable to meet Affinity's payment terms listed above?)

A Financial Assistance Program (FAP) is available to patients who are unable to pay for medical care. Affinity Health System offers assistance to patients because we believe all patients deserve high-quality health care, regardless of race, creed, color, gender, national origin, age, sexual orientation, handicap or ability to pay. Through the FAP, you may qualify for a reduction on your balance due to Affinity Health System. We will also help you make payment arrangements to cover the rest of your costs. For more information, call 1-866-832-1120 (Select option 1).

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 What happens if my doctor says I need to be hospitalized, but I don't have insurance?

Affinity Health System offers uninsured patients help from a Patient Financial Counselor. The Patient Financial Counselor will help you determine if you are eligible for any federal, state, local or private programs that help with the cost of hospital care. They can also help you with questions about social security disability, Medicaid and Badger Care eligibility, veterans’ benefits and more.

If the Patient Financial Counselor is unable to help you find some type of care coverage, she will explain our Financial Assistance Program and get you started on the application process.

For Affinity Medical Group please call (920) 727-8065
For Mercy Medical Center please call (920) 223-0484
For St. Elizabeth Hospital please call (920) 738-2027.

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 What is the difference between a preventive visit and an office visit?

Office visits are visits to the doctor for a specific problem. An office visit includes a problem-oriented history, exam and doctor’s recommendations.

Preventive visits are routine visits that evaluate a patient’s health. Visits include counseling, risk factor education and a doctor’s recommendation of appropriate next steps.

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 Which questions should I ask my insurance company?

If you have questions regarding your health insurance coverage, your best resource is your insurance company. It’s important to make sure you understand your insurance coverage before you receive treatment.

Here are some typical questions about insurance coverage:

  • Is this type of provider or service a covered benefit of my plan?
  • Do I need a referral for this visit?
  • Do I need prior authorization for this service?
  • Is my routine/preventive visit a covered benefit?  If yes, is there a maximum dollar amount on the policy?
  • Are there out-of-pocket expenses I am responsible for?  To what services do they apply?

    • deductible
    • copay
    • co-insurance
  • What are “usual and customary” differences?
  • Do I need to submit mental health claim to a different address?
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 I don't understand the insurance terminology. What do all these terms mean?
 AdministratorIndividual or third party firm responsible for the administration of a group insurance program.
 Allowable or maximum limitMaximum amount an insurer will pay for a given procedure or service.
 Allowed chargesCharges for services rendered or supplies furnished by a health care provider which would qualify as covered expenses and for which the insurer will pay in whole or in part subject to any deductible or coinsurance.
 Assignment of benefitsProvision in a health benefits claim form by which the insured directs the insurer to pay any benefits directly to the provider of care on whose charge the claim is based.
 Association group insuranceGroup insurance provided to a professional or trade association by which eligible members are covered under one master policy.
 BenefitPayable by the insurance company to a claimant, assignee or beneficiary when the insured suffers a loss covered by the policy.
 Civilian Hospital and Medical Program of the Uniformed Services (CHAMPUS)Government-provided medical care to dependents of service persons on active duty.
 Claim administratorAny entity that reviews and determines whether to pay claims to enrollees or physicians on behalf of the health benefit plan.  Claim administrators may be insurance companies or designated claims review organizations, self-insured employers, management firms, third party administrators or other private contractors.
 Claim formForm submitted to the payer by the provider of the service (i.e., facility or physician) for the patient to receive reimbursement for a drug or medical service.
 CodingProcess used to provide a uniform language that will accurately describe medical, surgical, diagnostic and treatment procedures and will thereby provide an effective means for reliable nationwide communication among physicians, patients and insurers.
 Commercial insurance companyPrivate insurance company that provides health care coverage to its subscribers.
 Coordination of benefitsSpecial term used to designate the anti-duplication provision designed by the group health insurance industry through the Health Insurance Association of America (HIAA) to limit benefits for multiple group health insurance in a particular case to 100 percent of the expenses covered and to designate the order in which the multiple carriers are to pay benefits.
 Co-paymentPayment made under a cost-sharing arrangement whereby an insured or covered person pays a specified amount (usually a percentage) per unit of service or per unit of time and the insurer pays the remainder of the cost.
 Cost-sharingShare of health expenses that a beneficiary must pay, including the deductibles, co-payments and coinsurance amounts.
CoveragePossible payment status of a health service or device for which the insurer might provide. reimbursement.
Covered servicesSpecific services and supplies for which third-party payers may provide reimbursement.
 DeductibleAmount the insured or covered person must pay up front for physician services or drugs before being eligible for any benefits.
DenialRefusal of a payer to cover a particular received medical service such as a drug or medical service.
Elective medical treatmentProcedures/therapies viewed by insurance companies as not medically necessary or life-threatening such as contraceptives, hearing aids, contact lenses, cosmetic surgery.
Employee Retirement Income Security Act (ERISA)Federal law establishing minimum participation, vesting, funding and termination standards for employer-sponsored pension plans.
Exclusion (Exception)Specified conditions or circumstances, listed in an insurance policy, for which the policy will not provide benefits.
Group insuranceArrangement for insuring a number of people under a single, master insurance policy.
Health maintenance organizations (HMO)Organization that provides for a wide range of comprehensive health care services for a specified group at a fixed periodic prepayment.
Indemnity contractInsurance against loss or injury.
Major medical planHealth insurance designed to cover the expense of major illness or injury, beginning where basic plans leave off.
Managed care

Those systems that integrate the financing and delivery of appropriate health care services to covered individuals by means of:

  • arrangements with selected providers to furnish a comprehensive set of healthcare services to members;
  • explicit criteria for the selections of healthcare providers;
  • formal programs for ongoing quality assurance and utilization review; and
  • significant financial incentives for members to use providers and procedures associated with the plan.
MedicaidState programs (with federal matching funds provided by Social Security under stipulated conditions) of public health assistance to persons, regardless of age, whose income and resources are insufficient to pay for health care.
MedicareFederally sponsored program under the Social Security Act that provides hospital benefits, supplementary medical care, and catastrophic coverage to elderly persons.
PolicyholderOwner of the insurance policy; the insured individual.
PreauthorizationPrior approval to perform proposed services, authorizing coverage for those services, given to a provider by an insurer.
Predetermination of benefitsRequest submitted before treatment from a provider to an insurer for indication of the amount of coverage available for a procedure or procedures.
Preexisting conditionAny physical and/or mental condition or conditions of an insured that exist prior to the effective date of coverage.
Preferred provider organization (PPO)Mode of health care delivery through which a sponsoring group negotiates price discounts with providers in exchange for more patients.  The sponsor may be an insurer, employer or third-party administrator.
PremiumPeriodic insurance payment.
Provider networkFacilities and/or physicians with whom a health insurer, HMO or PPO contracts to provide health services.
ReimbursementPayment of the actual charges incurred as a result of an accident or illness but which may not exceed any maximums specified in the plan of insurance.
RiderDocument that modifies or amends an insurance contract.
Self-insuranceMedical benefit plan established by an employer or employee group (or a combination of the two) that directly assumes the functions, responsibilities, and liabilities of an insurer.
Summary plan descriptionAbridged version of your contract, usually the document provided to you by your employer.
Timely filing deadlineSome plans will designate time periods or deadlines after which they will not allow you to file medical claims.

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1506 S. Oneida St
Appleton, WI 54915
(920) 738-2000

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