Billing and Insurance

Billing & Insurance

Online bill pay is now available through our online portal

We appreciate you choosing Colorado Mountain Medical, a partner of Vail Health. As part of our quality service, we feel it is important that patients and caregivers are well-informed of our payment policies. If you have any questions about billing, please do not hesitate to contact our financial customer service team at (970) 926-6350. Our financial team can help you understand your bills, explain what to expect during the billing process, help you make a plan to ensure payment of your health care expenses, and help you apply for financial assistance if needed. If you have questions regarding insurance, please contact insurance support at (970) 777-2996.

For patients who need assistance with their bill, Vail Health’s financial assistance policy has been increased to 550% of the federal poverty guidelines and is available to supplement a patient’s out-of-pocket obligations. For context, a family of four making $131,000 or less annually would be eligible for financial assistance. Vail Health will work with each patient needing financial assistance, including sensitivity to any changes in employment or income. For help with financial assistance, please contact one of our counselors at (970) 477-3116.

Be Aware of Third-Party Payment Services

Please be aware of third-party companies, like Doxo, that offer to pay your hospital bill for you. These companies are not affiliated in any way with Vail Health and often charge additional fees and can delay the processing of your payment, potentially leading to late fees on your account.

To avoid any unnecessary fees or delays, please use our official payment methods listed below.

If you have any questions or need assistance with your bill, please do not hesitate to contact our billing department at (970) 926-6350.

Insurance Guidelines

We encourage you to become familiar with the terms and conditions of your health insurance coverage and review any changes each year. Each insurance policy is different, depending upon:

Your insurance company and your specific policy.
The amount of coverage that is part of your healthcare benefits package.
Any provider network limitations defined by your insurance carrier.

Because insurance plans are constantly changing, you are responsible for charges that may deny for out-of-network or non-covered services.

To find out the details of your policy, including any prior authorization requirements, contact the Customer Service or Member Services Department at your insurance company (the phone numbers are on your insurance card or in your benefits book).

Medicaid & Other Insurance Enrollment Programs

Don't have insurance or need help getting it?
Our Community Outreach Team will work with you for Medicaid screening and enrollment. They will help you from application start to finish! If Medicaid is not available, the Community Outreach Specialists can assist connecting you with other insurance options. The Community Outreach Specialists provide bilingual services to anyone in our valley regardless of documentation status. To get started please call us at (970) 422-3039.

Colorado Mountain Medical Partnered Insurance Plans

We welcome all patients to our clinics and have established relationships with various insurance companies ensuring the broadest availability of in-network services are available to our patients. This information does not guarantee in-network benefitted coverage. Many insurance products have defined and limited provider networks and specialized products. Not all plans have out-of-network benefits. New Medicaid patients, over the age of 18, will be referred to Mountain Family Health for continuance of care.

This information is primarily designed to provide our patients with resources intended to help you make informed healthcare choices and have a better understanding of your potential financial obligations when visiting our clinics. We strongly encourage all of our patients, new and established, to verify you and your family’s in network benefitted coverage based on your insurance company’s plan.

Aetna
Anthem BCBS
Anthem BCBS of Colorado
Cigna Healthcare
Colorado Access CHP Plus
Colorado Medicaid
First Health
Humana
Kaiser PPO
Medicare

MultiPlan
Private Health Care Systems (PHCS)
Rocky Mountain Health Plans
Rocky Mountain Health Plan CHP Plus
Tricare - Referral / Authorizations are required
UC Health Plan Administrators
United Healthcare
United Healthcare Medicare Advantage
VA / TriWest Health Alliance - Referral / Authorizations are required

Was A Claim Denied By Your Insurance Company?

Sometimes, insurance companies need additional information to ensure your claim is processed correctly. Often, they're looking for what's known as “coordination of benefits.” This is a standard procedure where, every year, they determine if they're the primary insurance provider for your claims or if another insurer should be involved. We know navigating through these terms can be overwhelming, which is why we've prepared this guide. It's designed to help you understand coordination of benefits and guide you on what steps to take next.

Good Faith Estimate & No Surprise Medical Bills

If you are uninsured or a self-pay patient and would like to receive a "Good Faith Estimate" explaining how much your health care will cost, please visit our Estimate Your Cost of Care Page where you can find an online cost estimator. You can also call our insurance support team at (970) 926-6340. They would be happy to assist you. Learn more about your patient rights and a Good Faith Estimate.

Frequently Asked Questions

How do I contact financial customer support?

Hours: Monday – Friday, 8:00 AM – 4:30 PM

Phone: (970) 926-6350

Fax: (970) 926-6355

Payment Options
Online: Pay Your Bill Online

Phone: (970) 536-2406
Mail: Colorado Mountain Medical PO Box 842578, Kansas City, MO 64184-2578

Please be aware that sometimes other entities are involved with your care (labs, pathology, anesthesia, etc) which could result in separate bills being sent to you. In most cases, a summary description of services provided for that account should arrive about five days after care. At any time, you may request additional information about itemized charges by calling our financial customer service team.

What services are billed separately?

Colorado Mountain Medical does not bill for the following services:

Lab Services: Quest, Lab Corps., Vail Health Laboratory
Pathology Services
Vail Health Imaging
Vail Valley Surgery Center
Anesthesia Partners of Colorado

*This is not an exhaustive list.

What are my financial responsibilities?

Colorado Mountain Medical expects payment at the time services are rendered. Co-pays, co-insurance, deductibles and fees for non-covered services are expected at the time of service. If you are unable to pay your bill in full, please call (970) 777-2997 to set up a payment plan.

Occasionally, self-pay patients may receive a second bill post-appointment due to unforeseen services or delayed processing. For example, unexpected tests needed during your visit or administrative lags in updating your account may not be immediately billed. Although we strive to provide a complete cost at check-out, sometimes additional charges arise as we finalize your account details. We appreciate your understanding that healthcare billing can be complex and assure you that we aim for transparency in your financial responsibilities. Should you receive an additional bill, it reflects services essential to your care that were not included initially. Contact patient accounts at (970) 777-2997 to answer any questions you may have.

Payment Options

Online: Pay your bill online by using Visa, MasterCard, Discover or American Express.
Phone: (970) 536-2406
Mail: Colorado Mountain Medical
PO Box 842578
Kansas City, MO 64184-2578

My bill is higher than anticipated. Why is this?

Costs of service are reviewed on an annual basis and are comparable to other mountain resort areas. If you received an estimate of anticipated costs, and it does not match your bill, you must keep in consideration that the estimate is only a range of costs, and not an actual price. If you have further questions/concerns about your bill, please call patient accounts at (970) 777-2997.

Occasionally, self-pay patients may receive a second bill post-appointment due to unforeseen services or delayed processing. For example, unexpected tests needed during your visit or administrative lags in updating your account may not be immediately billed. Although we strive to provide a complete cost at check-out, sometimes additional charges arise as we finalize your account details. We appreciate your understanding that healthcare billing can be complex and assure you that we aim for transparency in your financial responsibilities. Should you receive an additional bill, it reflects services essential to your care that were not included initially. Contact patient accounts at (970) 777-2997 to answer any questions you may have.

How do I pay my bill?

Payment Options
Online: Pay Your Bill Online
Phone: (970) 536-2406
Mail: Colorado Mountain Medical PO Box 842578, Kansas City, MO 64184-2578

Be Aware of Third-Party Payment Services

To avoid any unnecessary fees or delays, please use our official payment methods listed below.

If you have any questions or need assistance with your bill, please do not hesitate to contact our billing department at (970) 926-6350.

Can I set up payment plan? How?

Although we prefer to receive payment in full within 30 days, a payment plan option may be available to you. To speak with someone regarding our payment plan terms and setup, please call (970) 777-2997 or set up a payment plan by clicking here.

What financial assistance do you offer? With whom do I speak for more information?

Vail Health offers financial assistance to eligible patients who meet our income requirements. Learn more about our financial assistance options.

Why can't you discuss my spouse's/adult child's medical information with me?

Due to the Health Insurance Portability and Accountability Act (HIPAA), we cannot discuss any person's account that is over the age of 18 without the patient's prior consent. Please visit our medical records page to learn more and acquire a consent form for the patient to sign.

I was happy/unhappy with the care I received at your facility. With whom can I share my experience?

To provide feedback regarding the care you received at Colorado Mountain Medical, please visit our Patient Advocacy page where you'll find multiple options for providing feedback.

Why doesn't my "Explanation of Benefits" match the amount you are billing me?

There are several reasons why your Explanation of Benefits (EOBs) may not match your billing statement. Multiple claims may have been submitted to your insurance company depending on the care you received. Insurance companies generally process each claim separately and will send individual EOBs for each claim. You will receive one statement for all patient balances for Colorado Mountain Medical.

Why am I getting a bill from Vail Valley Surgery Center?

Vail Valley Surgery Center bills separately from Colorado Mountain Medical. For questions about the Surgery Center's billing, please call (970) 476-8872.

The following providers also bill separately. The phone numbers for their billing departments follow.

Vail-Summit Orthopaedics: (866) 358-0202

The Steadman Clinic: (866) 942-2688

What is co-insurance?

Co-insurance refers to money that an individual is required to pay for services, after a deductible has been paid. In some health care plans, co-insurance is called "co-payment." Co-insurance is often specified by a percentage. For example, the employee pays 20 percent toward the charges for a service and the employer or insurance company pays 80 percent.

What does co-payment or co-pay mean?

Co-payment is a predetermined (flat) fee that an individual pays for health care services, in addition to what the insurance covers. For example, some HMOs require a $10 co-payment for each office visit, regardless of the type or level of services provided during the visit. Co-payments are not usually specified by percentages.

How does my deductible figure into all of this?

The deductible is the amount an individual must pay for health care expenses before insurance (or a self-insured company) covers the costs. Often, insurance plans are based on yearly deductible amounts.

What does pre-authorization mean? How do I get it?

Pre-authorization is an approval by one's insurance company for the policy holder or dependent. Your insurance may require an authorization for surgical or other specific services. It is not a guarantee of benefits or that the insurance company will pay your claim. If you have questions about the services you are scheduled to receive, please contact your insurance company to understand the need for prior authorization.

Financial Counseling - Understanding Common Terms & Definitions

Co-Insurance

Coinsurance is the percentage of costs you pay after you've met your deductible.

Copayment or Copay

A predetermined payment amount that is paid by a patient at the time of receiving services. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.

Deductible

A deductible is what you pay annually for health services before your insurance company pays its share. For instance, if you have a deductible of $1,000, your insurance plan might not start covering its share of your bills until you’ve paid $1,000 for healthcare in a given year. However, plans often cover the cost of things like preventive care doctor’s visits even before you’ve paid your full deductible amount.

Explanation of Benefits (EOB)

An EOB is a statement from your health insurance provider describing what costs it will cover for medical care or products you’ve received. The EOB is generated when your insurance company has completed processing the claims for the services you received.

Facility Fees

These are fees associated with the location that you received care.

Financial Assistance

Financial support to help minimize financial burdens resulting from a medical condition. Eligibility is based on household income and assets. Vail Health provides financial assistance on a sliding scale to individuals with an annual household income up to 550% of the Federal Poverty Guidelines.

Guarantor

The Guarantor is the person who is financially responsible to pay the patient's bill. If the patient is a child, the responsible party may be the child's parent or legal guardian.

Insurance Adjustment

This is the amount the healthcare provider has agreed not to charge based on the insurance contract agreement.

Insurance Payment

The amount your health insurance provider has already paid.

Patient Payment

The total amount already paid by the patient.

Payment Plan

An arrangement with the bank where the borrower agrees to pay back a certain amount of money each month to repay the total debt. The payment plans available on our bill pay website can extend up to 12 months with a minimum payment of $25/month and have 0% interest.

Primary Insurance

A health insurance plan that covers a person as an employee, subscriber, or member. Primary insurance is billed first when you receive health care. For example, health insurance a person receives through their employer is typically their primary insurance.

Professional Fees

These are the fees associated with your physician that provided care. For example, if you received an MRI, these images will be read by a Provider which results in a professional fee cost.

Secondary Insurance

A health insurance plan that covers you in addition to your primary insurance plan. Typically, secondary insurance is billed when your primary insurance plan is exhausted and may help cover additional health care costs. For example, if a person already has insurance through their employer and chooses to enroll with their spouse’s health insurance plan (if allowed), that coverage would become their secondary insurance.

(970) 363-5429

(970) 926-6340