Billing Information & Financial Services
Thank you for choosing the M Health Fairview health system — a collaboration between the University of Minnesota, M Physicians, and Fairview Health Services — for your healthcare needs. We understand that health services billing can be confusing, so we’re here to help.
The information on this page is designed to help you understand the basics of your bills, answer common billing questions, and provide you with information if you’re having trouble paying your bills.
Common Billing Topics
If you receive care in one of our many M Health Fairview clinics, you will receive one bill for all services. The bill will include any lab work, radiology, provider charges, etc.
You may also receive a Fairview bill even if you were not seen at a Fairview location. This occurs most often when a health care provider sends a lab culture or biopsy to a Fairview lab for testing. When this occurs, you will receive a bill from our lab. Usually the doctor will send your insurance information (if any) along with the lab work. The lab will then bill your insurer for services.
There may be some pre-payment involved in your care. M Health Fairview collects estimated patient liabilities, including co-payments, co-insurance amounts, and known unmet deductibles at the time of registration.
To plan for this, you can call the customer service number on the back of your insurance card to find out if you will have a co-payment, co-insurance, or unmet deductible for your upcoming visit.
Your insurer can also provide information about what they do and do not cover. This will help you plan for the cost of your care, visit, or procedure.
To avoid surprises about your care costs, check with your insurance company before your visit and talk about your financial coverage, plus your rights and responsibilities. This could include whether you need a referral or prior authorization (permission) for your appointment.
You can login to mychart to get a cost of care estimate.
Medicare rules require hospital-based clinics to bill some services as two separate charges. One charge is for the provider's services (provider fee). The other charge is for the costs of nursing staff, supplies, equipment and building expenses (facility fee).
So what’s divided into two charges? Clinic services (including office visits and some treatments given in the office), X-ray, lab, and EKG charges are the most common types.
Don’t worry, this doesn’t mean you’re billed twice for the same service. The total of the two charges is equal to the full charge for the service. Fairview’s hospital-based clinics will submit all claims to Medicare.
For people with Medicare supplemental insurance, we file separate charges for the provider and facility fees to your Medicare supplemental insurance.
Here are a few more Medicare terms and definitions:
Medicare crossover
This is a benefit that is offered by Medicare. The patient allows Medicare to process claims and payments to the patient's secondary plan.
Medicare Part D
This is a plan that provides prescription drug coverage through Medicare. Part D co-pays aren’t covered by Medical Assistance because Medicaid and Medicare each require their own co-pay.
"Donut hole"
The term "donut hole" refers to a gap in coverage under Medicare Part D (prescription drug program). Under the standard benefit, there is a gap in coverage between the initial limit and the catastrophic threshold. Within this gap, you would pay 100 percent of the cost of your prescription drugs. The government agencies and insurers prefer the term "coverage gap," but "donut hole" is more widely used.
For patients needing financial assistance, M Health Fairview offers help. Treatment will never be denied because a person is unable to pay.
For further questions, you can call our helpline:
Monday – Friday, 8:00 a.m. to 4:30 p.m.
612-672-6724 or 1-888-702-4073
Beginning January 1, 2021, the U.S. Department of Health & Human Services and Centers for Medicare & Medicaid Services also requires hospitals and health systems to disclose all standard charges. Negotiated rate information is available here, listed by hospital:
- M Health Fairview Lakes Medical Center
- M Health Fairview Northland Medical
- M Health Fairview Ridges Hospital
- M Health Fairview Southdale Hospital
- M Health Fairview St. John’s Hospital
- M Health Fairview St. Joseph’s Hospital
- M Health Fairview University of Minnesota Masonic Children’s Hospital
- M Health Fairview University of Minnesota Medical Center
- M Health Fairview Woodwinds Hospital
Gross charge (a.k.a, “list prices”) information is available here:
You have the right to an estimate of the charges for care. You also may speak to a financial counselor before you agree to a suggested procedure. There are two different ways to obtain an estimate for the cost of care:
- View our Fairview online patient estimate tool
- Submit a pricing inquiry request form
If you have additional questions, you can call one of our Financial Service representatives at 612-672-1048. You can also view hospital pricing and compare charges on the Minnesota Hospital Association website.
Minnesota statute 62J.812 requires our primary care clinics to post charges and payments for 25 of the most commonly billed procedures, and the average payments or reimbursements received for those services from government and commercial insurance. You can review this information here:
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M Health Fairview Clinics, formally known as Fairview Clinics
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M Health Fairview Clinics in the east region, formally known as HealthEast
Prices listed do not reflect what you may owe for your care. The amount you may owe out of pocket for your care depends on the type of insurance you have and your insurance’s contracted rate with our health system.
If you would like to get an accurate estimate of the payment rate M Health Fairview will receive related to your care, and/or an estimate of what you may need to pay out of pocket, please contact your insurance company.
Out-of-Pocket Cost Topics
Your bills depend on the clinics you visit and the services you receive. The out-of-pocket costs that you pay may be different depending on whether you receive care or tests in a freestanding or hospital-based clinic.
Because of your own health insurance plan, an outpatient hospital visit may cost more out-of-pocket. It may be through an increased co-pay, co-insurance, or deductible amount. Your insurance company can explain the cost difference between services in a hospital based clinic and those in a freestanding clinic.
If your insurance plan calls for a our co-pay, it’s due when you visit. We accept cash, personal check, and credit/debit cards (Visa®, MasterCard®, American Express® and Discover®).
Before your visit, you may want to check with your insurance company for coverage, referral, and payment options. Ask about the cost difference between outpatient services in a hospital-based clinic versus a freestanding clinic.
Hospital-based: The medical center owns some of our clinics (hospital-based).
Freestanding clinics: The clinic is not owned and operated by a hospital.
M Health Fairview’s Hospital-Based Clinics
M Health Fairview Clinics & Surgery Centers - Minneapolis
Advanced Treatment Center
Blood and Marrow Transplant Clinic
Breast Center (Clinic services only. Imaging services billed as freestanding clinic)
Center for Bleeding and Clotting Disorders
Center for Lung Science and Health
Delaware Infectious Disease Clinic
Heart Care Clinic
Hepatology (Liver) Clinic
Masonic Cancer Clinic
Multiple Sclerosis Care (Neurology Clinic)
Nephrology (Kidney) Clinic
Rheumatology Clinic
Solid Organ Transplant Clinic
Other Specialty Clinics
Discovery Clinic (pediatric)
Explorer Clinic (pediatric)
Eye Clinic
Journey Clinic (pediatric)
Lakes Cancer Clinic
Maternal Fetal Medicine Clinic
Psychiatry Clinic
Ridges Cancer Clinic
Sleep Medicine Center (Riverside)
Southdale Cancer Clinic
Women’s Health Specialists
University of Minnesota Health Heart Care (imaging services at most locations are considered hospital-based)
There may be exceptions for specific programs or services within a clinic or for imaging or anesthesiology.
The following hospital-based clinics of University of Minnesota Medical Center charge a facility fee: Lakes Cancer Clinic, Ridges Cancer Clinic, and Southdale Cancer Clinic. Patients at these clinics may receive a separate charge or bill for the facility fee.
Facility fees at hospital based locations:
62J.824 FACILITY FEE DISCLOSURE. (a) Prior to the delivery of nonemergency services, a provider-based clinic that charges a facility fee shall provide notice to any patient stating that the clinic is part of a hospital and the patient may receive a separate charge or billing for the facility component, which may result in a higher out-of-pocket expense Adding- Understanding Your Bills If you receive treatment at one of our M Health Fairview hospitals or a hospital-based clinic, you will most likely receive two bills. One will be for physician and care team services (this will often be from M Physicians). The other bill will be from Fairview Health Services for hospital services (nursing, equipment, and facilities). Medicare Medicare rules require hospital-based clinics to bill some services as two separate charges. One charge is for the provider's services (provider fee). The other charge is for the costs of nursing staff, supplies, equipment and building expenses (facility fee).
Financial Assistance
Financial Assistance Programs
We offer financial help to our patients who cannot pay all or part of their medical bills.
Speak to a Financial Counselor
Our financial counselors can answer questions about possible costs and coverage, as well as discuss the options you have if you don’t have enough - or no - insurance for your care.