Frequently Asked Questions - Insurance
Here are some frequently asked questions and answers regarding insurance.
How do I know if my health plan includes Mercy Medical Center?
Mercy participates in most major health plans in our community. In addition, please review your health plan provider directory and/or consult with your health plan to confirm coverage.
How will Mercy Medical Center know in which health plan I participate?
Please present your current health plan identification card when you register for inpatient or outpatient services at Mercy.
What is the difference between an HMO and a PPO?
Health Maintenance Organizations (HMOs) require a patient to select a Primary Care Physician to coordinate his or her care. Most HMOs provide care through a network of hospitals, doctors and other medical professionals, that as a patient, you must use to be covered for that service.
Preferred Provider Organizations (PPOs) provide care through a network of hospitals, doctors and other medical professionals. When patients utilize healthcare providers within the network, they receive a higher benefit and pay less money out of their pocket. Services received by a non-participating hospital or doctor may still be covered, but often at a reduced benefit level.
What does "in-network" and "out-of-network" mean?
If you receive your health care services from a hospital, physician or other health care provider that participates in your health plan, they are often referred to as "in-network." Hospitals, physicians or other health care providers who do not participate in your health plan may be referred to as "out-of-network." See more about common insurance terms.
How do I know if my health plan requires a referral or pre-certification for a service?
Your benefit book or provider directory should provide this for you. If not, call the customer service phone number listed on your insurance identification card.
What should I do if my health plan includes Mercy Medical Center as a participating provider, but I receive an explanation of benefits stating I am out-of-network?
Consult your health plan.
What if I have questions on my bill?
If you have questions about your Mercy Medical Center bill, or feel that it is incorrect, call (319) 398-6856 between 9 a.m. and 4 p.m. Monday through Friday. Please have the Patient's name, account number(s) listed on the bill or the patient's social security number ready when you call.