Accepted Insurance

Here you will find a list of the most popular insurance packages accepted at University Medical Associates, Inc. If you do not see your insurance company listed please contact your insurance company to find out if UMA is in network.

UMA accepts the following insurances:*

AETNA
Anthem BCBS
Bankers Life & Casualty
Central Benefits
Cigna
EBMC – Big Lots Associate Benefit Plan
Goodyear Medical Benefits
Harrington Benefit Services
Humana
Medicaid Packages for Ohio
Medical Mutual
Medicare Packages
Molina
Ohio Carpenters Health & Welfare Fund
One Nation
Professional Benefits Administration
TriCare
UFCW Unions & Employers Health & Welfare Plan
Unison
United Health Care
United Mine Workers
VA Health Administration
Bureau of Worker’s Compensation

* This list is for informational purposes only; it is not meant to be comprehensive or all-inclusive of all insurance packages accepted in our offices. This list is subject to change. UMA may not participate in all products or policies offered by a company. Please check with your insurance to confirm network participation.

Before your appointment, check with your insurance company to determine your policy’s benefits including any co-payments, deductibles and co-insurance amounts. Co-pays are due the day of your appointment.

Billing Checklist

During registration, we will collect important information that will help identify you and ensure that we have correct information to bill your insurance. In order for us to have complete information, please bring these items necessary for registration:

  • Insurance Cards
  • Identification, driver’s license
  • Copay amount as listed by your insurance policy
    • For your convenience we accept VISA and MasterCard, cash or check
  • If we will not be billing insurance for your visit, a $50.00 payment is required and you will be billed the balance.

Obtaining Referrals

Check with your insurance company to determine if a referral is necessary before your visit with our providers. Insurance policies often require referrals to see specialists or to see a primary care provider not listed on your policy.

Checking Coverage with Insurance Company

Always check with your insurance to verify your policy’s benefits and any possible requirements for your appointment. As a patient, it is your responsibility to confirm you are covered for any services and to provide accurate information for billing.

Financial Policies

Download our PDF brochure for further information (175kb)

Billing Statements may be received as paper to your mailing address on file or you may choose to receive paperless statements through your Patient Portal. Our statements will list any services provided at UMA. This could include the visit with your provider, any procedures or lab tests performed in the office. If procedures or lab tests are performed at an outside facility you will receive separate billing for those services.

How to Pay Your Bill or Questions about Your Bill

We offer several ways to pay your bill.

  • Online through your Patient Portal, requires log-in
  • Online with Quickpay
    • A Quickpay Code is listed on each billing statement
    • Enter this code on the Patient Portal page (link)
  • At your provider’s office
  • Mail payment to : UMA, PO Box 8767, Belfast, Maine 04915-8767
    • Include account number on payment
  • Pay by Visa or MasterCard, or for questions about your bill, call our offices
    • Family Medicine, Geriatrics, Endocrinology or OMM call 740-593-4604 or 740-593-2522
    • Express Care call 740-594-2456
    • Internal Medicine, Dr. Sammons, call 740-594-4722
    • Ohio University Campus Care call 740-593-1660
    • Pediatrics call 740-593-4688
    • UMA does offer Payment Plans to allow monthly payments if you are unable to pay your balance in full, contact your provider’s office to make arrangements.

Level of Service Determination

There are many parts that go into assigning the level of service to a visit. Insurance companies require “codes” to be submitted and each code represents a service. Different codes are given if you are a new patient or if you are established with the provider. A visit is considered new if a patient has not seen the provider in the past 3 years. The reason for the visit also plays a part. If the visit is for a condition or a check-up on a condition, insurance requires certain codes to indicate the visit is a problem focused visit. If the visit is only for preventive services, no problems exist, or a physical examination, these are yet another set of codes. Office visits can be billed at 5 levels depending on number of conditions, any new issues needing addressed, the complexity of tests reviewed or needing ordered, treatment options, and time spent with the provider.

Glossary of Terms

Allowed Amount – Maximum amount on which payment is based for covered health care services.

Beneficiary – Any person entitled to insurance benefits based on the rules for eligibility according to a specific insurance plan.

Claim – A bill for medical services rendered, typically billed to the insurance company by the healthcare provider.

Coinsurance – Your share of the cost of a covered health care service, calculated as a percentage of the allowed amount for the service. You pay coinsurance after you’ve met your deductible and copayme

Contractual Adjustment – Amount discounted from a service as an agreement with the insurance company.

Coordination of Benefits – This is the process by which a health insurance company determines if it should be the primary or secondary payer of medical claims for a patient who has coverage from more than one health insurance policy.

Copayment – A fixed amount your health insurance may require that you pay for a medical service.

Deductible – A specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims.

Dependent – A spouse, child, or other individual a policyholder may list to be covered under an insurance policy.

Exclusion – Specific conditions, services or treatments for which a health insurance plan will not provide coverage.

Explanation of Benefits – A statement from your insurance company listing services billed by a provider, how those charges were processed, and the total amount of patient responsibility for the claim.

Limitations – A term referring to any maximums a health insurance plan imposes on specific benefits.

Network – The facilities and providers your health insurer has contracted with to provide services.

Out-of-pocket maximum – The most you will have to pay for covered services in a policy period.

Pre-existing conditions – A health problem you had before the date new health coverage starts.

Primary Care Provider or PCP – A physician, nurse practitioner, or physician assistant, who provides, coordinates or helps a patient access a range of health care services. Your insurance policy may require your choose a PCP based on your plan.