To help you better understand your financial responsibility for the services provided by Mayfield physicians and nurse practitioners please review our Patient Financial Responsibility Policy [PDF download].
Depending on whether you have insurance, and the extent of your coverage, you may be asked to make a payment at the time of your visit. We suggest that you contact your health insurance plan before your appointment to verify benefits and coverage and to confirm that your Mayfield physician is a participating provider.
Is my Mayfield provider covered by my insurance plan?
To find out if Mayfield is a participant in your healthcare insurance plan, you will need to call the phone number on your insurance card. If requested, Mayfield's Tax ID number is 31-0588183.
Mayfield is a participating provider with these insurance plans:
- AARP Medicare Complete
- Buckeye Health Plan (Medicaid only)
- Care Source (Ohio Medicaid Just For Me)
- Direct Care America/Primary Health Services (DCA/PHS)
- Gateway Health
- Healthsmart (IHG)
- Humana/Choice Care
- Kentucky Medicaid
- Medical Mutual
- Molina (excluding Managed Medicare)
- Ohio Health Choice Plan (OHCP)
- Ohio Health Plan/Great West
- Ohio Medicaid
- United Healthcare
- Wellcare of Kentucky Managed Medicaid
- Wellcare of Kentucky Medicare
- Workers Compensation
If you don’t see your insurance plan listed, you can contact us to verify whether we participate with your plan.
Your co-payment, co-insurance and deductible are due at the time of your visit. If you require surgery, a payment request may be made prior to scheduling. For your convenience, Mayfield accepts cash, personal checks, and most major credit cards.
You will not incur any out-of-pocket expense for the Priority Consult review. However, if your insurance company is contracted to pay Mayfield Clinic for the surgeon’s review, this payment will be reflected on the Explanation of Benefits (EOB) from your insurance company. This is for your information and is not a bill.
If the surgeon recommends an appointment, treatment or procedure with a Mayfield physician, physical therapist, nurse practitioner or physician assistant, then that appointment will be billed to your insurance, and you may incur out-of-pocket expenses.
Please remember to bring your insurance card, Medicare or Medicaid card with you to your office visit. If you do not bring your card, we will ask that you pay at the time of your visit.
Health Plan or Managed Care Plan
If you are enrolled in a health plan or managed care plan, your co-payment will be collected before you see the doctor.
If you are enrolled in a Managed Medicaid plan, your co-payment will be collected at the time of your visit. No payment is required for traditional Medicaid. A physician referral is required for both Medicaid and Managed Medicaid patients.
If you are enrolled in traditional Medicare, 20% co-insurance will be collected at the time of your visit. However, if you have secondary coverage to Medicare, no payment is required.
If you are enrolled in Managed Medicare, your copayment will be collected at the time of your visit.
Workers' Compensation and Self-Insured Employer
If you are being seen for a work-related injury, your claim must be approved by the Bureau of Workers' Compensation or self-insured employer.
If approved, please provide the following information: date of injury, claim number, the name and billing address of the managed care organization that administers your benefits, and the name of your treating physician.
If your claim is pending or not approved, Mayfield will submit a claim to your health insurance company. If you do not provide your workers' compensation claim number, and you do not have health insurance, we will ask that you make payment at the time of your visit.
If Mayfield Clinic is not a participating provider with your insurance plan, we will assist you in obtaining benefits from your insurance company, but ask that you make payment at the time of your visit.
If you do not have health insurance, we ask that you make payment at the time of your visit. Please contact Mayfield's financial coordinators at 513-569-5300 if you have questions.
If you have any questions concerning a refund on your account, please contact Mayfield's Patient Accounting Department at 513-569-5300 or 800-325-7787.