Frequently Asked Questions

I received a statement in the mail from PMG, what is it for?

Most of the services provided by PMG are for professional physician services addressing the needs of intensive care newborns. Upon request by an OB/GYN or Emergency Room physician, PMG provides consultative services to a pregnant woman who may have a critical situation upon delivery. The statement you were mailed is for Neonatology services that you or your baby received from a physician employed by PMG.

Who can I contact if I have questions about my bill?

If you have questions regarding your billing statement, please contact Erin Fanning.

*Telephone: 559 573 8046

Email: erin@greatwesterndoctors.com

Fax: 559 299 7255

*If you contact us during business hours, Monday-Friday and we are unavailable please leave a message and you will receive a response within 24 hours.

NOTE: PMG respects the medical confidentiality of its patients and we are fully compliant with all HIPAA (Health Insurance Portability Accountability Act) rules and regulations.  For this reason, when we communicate with anyone regarding a billing statement or account status, we must be able to ensure we are communicating directly with the parent and/or legal guardian of our neonate patients. Therefore, if you would like to contact us to discuss your statement, please ensure you provide us with your account number so we can verify your identity.

Who will bill my insurance?

PMG will bill the health insurance company on your behalf. If the bill is unpaid because the insurance company states you no longer have health insurance coverage, or the child is not yet covered, we will send you a statement. If your health insurance coverage is through Medi-Cal, you may receive a statement if we used the Mom’s ID and we need the baby’s ID.

Why am I being asked for my insurance information again? I gave my information to the hospital.

Our physicans are not employed by the hospital. Physicans must request their own patient information because your health insurance coverage will be different for a physician vs. hospital services. For these reasons, physicians and hospitals must maintain separate health insurance records.

My baby was in the hospital several weeks ago, why haven’t I received a bill?

Depending on how quickly the insurance company processes the bill, it may take 6 to 12 weeks for you to receive a bill. If your insurance company denies, we often try to appeal the claim and rebill without having to contact you. This happens frequently due to newborn coverage with employers as well as Medi-Cal/CCS eligibility which only updates monthly.

Why did my billing statement have an adjusted amount?

“Adjustment” refers to the portion of your bill the hospital or doctor has agreed not to charge.

I can not afford to pay the current balance due on my account, what should I do?

PMG understands healthcare costs can be very expensive. We are happy to set up a payment plan for you and alleviate collections phone calls.

Why do I receive separate bills from the hospital and physicians?

You may receive more than one bill for services rendered during your hospital visit. Physician charges are billed separately and may include services from Radiologists, Anesthesiologists, Cardiologists and Pathologists.

When will my insurance company settle my account?

Although each insurance company is different, we generally expect full payment from insurance companies within 2 months from the day of billing. If your insurance company does not pay within this time frame, we may send you notification of their non-payment and request that you contact them to send the payment.

My insurance company tells me that PMG is out-of-network. What does this mean?

Most insurance companies have physician networks which are contracted to pay a pre-negotiated amount. Out of network or out of area are services and/or doctors that are not included in a particular network. PMG services are considered emergent services, not elective nor scheduled. PMG staff will work with your insurance company to make sure that as a member you are not penalized for this status.

How will I know how much I need to pay?

Once we receive a payment or denial from your insurance company, we will mail you a statement which shows the payment due. The amount will be the same as noted on the Explanation of Benefits (EOB) which is received from your insurance company. Payment is due at the time you receive the statement.

Who can I contact regarding questions about Medi-Cal or California Children’s Services?

Please review their websites listed below:

Medi-Cal – http://www.medi-cal.ca.gov/

California Children’s Services – http://www.dhcs.ca.gov/services/ccs

Where can I find out more information about Community Regional Medical Center’s NICU?

The link for CRMC’s NICU below will provide you with general information regarding what to expect if your child is in the NICU, an overview of the facility, visitation guidelines and contact information.

http://www.communitymedical.org/our-facilities/community-regional-medical-center/neonatal-intensive-care 

Can I volunteer in the NICU at CRMC?

Yes! Volunteering for the NICU (including our “Baby Cuddling” program) is administered through Community Regional Medical Center’s Volunteer Services, please visit this website for more information about the process to become a volunteer and download the application: http://www.communitymedical.org/careers/volunteering