Billing Assistance

Who can I contact if I have a question regarding my bill?
If you have a question regarding your bill with Sigma Medical Group, please call (765) 449-2410 or toll free, 1-866-895-8891. A representative is ready and willing to assist you.

I am covered under a HMO, why am I getting a bill?
Although most medical services are covered under an HMO plan, there are some services that are classified as non-covered services. Each plan defines what those non-covered services are, and describes them in the information given to each plan holder. It is the responsibility of the plan holder to understand their benefits.

I paid my co-pay at the time of my visit, why did I receive a statement in the mail requesting payment?
A statement may be generated before the co-pay is posted to the patient's account. Payments are posted at a central site, and there are situations where that day's payments were not posted before the statement was generated.

Why didn't my physician advise me that my physical would not be covered under my insurance plan?
There are hundreds of different plans with hundreds of variations as to the benefits offered. Our physicians have no way of knowing each patient's coverage. It is the responsibility of each patient to know their individual coverage.

Most insurance plans will not cover sports, school, DMV or employment physicals. If you are seeing your physician for this type of physical, you will need to be prepared to pay for the visit.

Why does it take so long to receive a statement from Sigma Medical Group?
If a patient is covered under an insurance plan, a claim is generated within a few weeks of the time the medical services were received. Claims are sent either electronically or by paper, depending on the capabilities of the insurance plan. Claims sent electronically will usually be paid within a 30 day time period. Claims sent via paper will usually take over 45 days before they will be paid.

If a patient has a secondary insurance, the secondary insurance cannot be billed until the primary insurance pays their portion. A claim form is then generated, the Explanation of Benefits from the primary insurance is attached to the secondary claim, and the claim is sent, via paper, to the secondary insurance. It can take up to 90 days before the secondary insurance pays the balance of the claim.

If there is a portion left over that is the responsibility of the patient, a statement is generated. This could be 6 months to 9 months before all of the above activity is completed.

Why can't my diagnosis be changed so my insurance plan will pay for the service?
Only physicians can diagnose patients. It is illegal to create a diagnosis just to satisfy an insurance company.

Why did I receive a bill for a co-pay for my X-ray services?
Many health plans have a separate co-pay for ancillary services, such as x-ray and laboratory testing. The benefit information from your health plan should inform you if your coverage requires a co-pay for these ancillary services. Check with your health plan.

If you were billed by Sigma and your health plan does not require a separate co-pay for your ancillary services, contact our billing department and they will adjust your account.

Why does my statement, at the bottom, show an unapplied or prepayment?
Sigma's patient accounting system is defined as a line item system. All charges are detailed out and all payments are applied against individual charges. When a payment has been received and no charge has yet been posted, that payment will show as either prepayment or an unapplied payment. When the appropriate charge is posted to your account, the prepayment or unapplied payment will be matched to the charge.

What is my deductible?
Sigma Medical Group does not have access to your individual benefits. Your benefit information will tell you the amount of your deductible. You can call the number on your insurance card and they will be able to advise you of your deductible. They can also tell you if you have satisfied your deductible for the calendar year.