Know what to do if your doctor’s office asks for payment at the time of your visit.

When to Pay for In-Network Services

  • when-to-pay-2.gifPrint a letter to bring
    along on your next doctor's visit.

  • when-to-pay-3.gifPrint a wallet card to keep with your medical ID card.

  • when-to-pay-1.gifShould you pay? Call the LM HealthWorks Plan at 1-877-458-4975.

You’re at an in-network doctor’s office and the staff asks for payment up-front. Or you’re scheduled for surgery with an in-network provider and the doctor’s office requests payment before the procedure is performed. Here’s what you should know and do if this happens:

The facts
Although it is standard and preferred that providers do not ask for payment at the time of service, LM HealthWorks Plan and Aetna provisions do allow in-network providers to collect payment at the time of your visit. It is recommended that they file a claim on your behalf, wait for the claim to be processed and paid, then bill you for your portion of covered expenses (as applicable). Here’s how you can help make this happen:

What to do

  • Print this letter and bring it to your next doctor’s appointment. It explains how the LM HealthWorks Plan works and asks that the doctor’s office staff submit a claim instead of requesting payment at the time of service.
  • Print this wallet card and keep it with your medical ID card. It contains the same basic information as the letter, only in shorter form.
  • Ask the doctor’s office staff to make a copy of the letter or wallet card and keep it in your file for future reference.
  • Share the information on this page with other family members, and print copies of the letter and wallet card for them to use.
  • If your doctor’s office still requests payment, call the LM HealthWorks Plan at 1-877-458-4975. Customer service representatives can tell you where you are in the plan — the balance of your HealthFund, how much of the deductible you’ve met and the coinsurance amount for the services you’re receiving. They can tell you whether or not you should pay, and how much.

Why filing a claim is better
Filing claims ensures the proper use of your HealthFund dollars and applies the correct amount to your deductible. It also makes sure you are billed according to the fees your provider has negotiated with Aetna, which saves you money.

Call the LM HealthWorks Plan at 1-877-458-4975, Monday – Friday, 8 a.m. to 6 p.m., local time.

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