Patient Responsibilities

As a patient, it is in your best interest to know if your plan is contracted with the University of Chicago Medicine and Physicians Group, and to understand your insurance plan benefits and your responsibility for any deductibles, co-insurance, or co-payment amounts prior to any visit. You may have different deductibles, co-insurance, or co-payment amounts, depending on the contracted status of your insurance company.

It is also important to understand your insurance plan’s current benefit and coverage rules. Policies and coverage determinations may vary from year to year. Please be aware that our outpatient visits are billed as "hospital based outpatient clinics," and not private doctor office visits. Some insurance plans pay different benefit levels for each type of visit.

You may receive two bills for the treatment provided to you at the University of Chicago medical clinic -- one from the University of Chicago Medicine and one from the University of Chicago Physicians Group. For outpatient clinic visits, the University of Chicago Medicine bill will include physician fees associated with an outpatient office visit and other non-physician charges related to the visit and the tests and equipment used to provide your care at the University of Chicago medical center. The University of Chicago Physicians Group bill will include physician fees associated with diagnostic testing and most outpatient procedures.

Please make sure that both your physician and hospital are listed as a contracted provider by your insurance company. It is possible that only the physician or only the hospital is contracted with your insurance plan. If not listed, contact your plan's customer service department or the University of Chicago's Office of Managed Care at (773) 834-4730 to verify.

Doctor and patient

If the hospital and/or the physicians are not listed as a contracted provider and/or are not in your insurance company's network, we are still happy to accept your insurance and provide you with services. If your policy has out-of-network benefits, your insurance plan may still cover the services provided to you at the University of Chicago Medicine and Physicians Group. However, you may be responsible to pay a higher amount out-of-pocket than if you receive services from an in-network provider. Your insurance company's customer service representative can help verify your benefits and out-of-pocket costs. Should you require additional assistance regarding your out-of-pocket cost, we can provide you with financial assistance options.

Also, not all services are covered in all insurance contracts. If your insurance plan benefits do not cover a service or procedure, you can be held personally responsible for payment of these charges. To find out what your insurance plan benefit covers and what your financial obligation may be, call the customer service or member services department of your insurance company (the phone numbers are on your insurance card). Your employer's human resources department may also be a source of information and assistance.

Patients with insurance questions or concerns may also contact the University of Chicago's Office of Managed Care at (773) 834-4730.