Frequent Questions

What insurance companies does the Mayo Clinic accept?
Mayo Clinic will file to any insurance company authorized by you, however please contact your employer or insurance company if you have questions about coverage. An insurance contract between your insurance company and Mayo Clinic does not guarantee that your claims will be paid in full. You are responsible for payment of services not authorized by your insurance company.

Why did I receive more than one itemized statement for my last visit to Mayo?
If you are hospitalized, for example, you will receive two itemized statements:

• One from the hospital for your room, meals, nursing care, laboratory services, and other related services.
• One from the Mayo Clinic for your physician services and tests.

Why is there a usual, customary, and reasonable (UCR) denial from my insurance carrier?
Insurance coverage varies among individual insurers and among individual policies. Many insurance companies limit payments using their own fee schedule of "usual, customary and reasonable" (UCR) allowances. Mayo's fees/charges may differ from insurance companies' fee schedules. We suggest you check with your employer or insurance agent about coverage. You are responsible for payment of your account regardless of the amount of benefits provided by insurance including balances due to UCR limitations.

When an insurance company denies part of a claim because of "usual, customary and reasonable" (UCR) allowances, is there an appeal process?
In order to exercise your appeal rights, you must personally lodge a formal appeal within a certain time limit. Mayo cannot advise you whether you should file an appeal and it does not have the right to file an appeal on your behalf. Most insurers are required to respond to your request for appeal within 30 to 60 days.

Does Mayo send my doctor's referral letter to the insurance company?
No. Mayo does not provide this information to your insurance company as claims are electronically filed whenever possible.

My insurance company will not pay until they receive my doctor's referral letter. What should I do?
Ask your referring doctor to send a copy to your insurance company on your behalf.

How do I file supplemental insurance?
Attach a copy of your explanation of benefits form that you received from your primary insurance company to a copy of the itemized statement that you received from Mayo Clinic. Send both documents to your supplemental insurance company.

It is your responsibility to coordinate billing and payment information between the two insurance companies.

What is the difference between a guarantor number, a Mayo Clinic number and a visit number?

• Guarantor account numbers equate to the head of household mailing number. Several members of the same household can be part of this account.
• Mayo Clinic number is a patient's personal identification number. It is unique and is theirs for life.
• A visit number is created for each episode of care and is attached to the end of the Mayo Clinic number. This number is used to track services and payments.

Does Mayo participate with the Medical Assistance program?
Mayo Clinic participates with the state Medicaid programs of Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wisconsin. This participation allows Mayo Clinic to provide services to and bill for patients from these states, with some restrictions. However, individual coverage may depend on your obtaining a written pre-authorization from your state Medicaid program.

If you have coverage through a state or Medicaid-sponsored managed care health plan, you may also need a referral from the health plan to receive coverage at Mayo Clinic. We recommend checking with your state's Medicaid office or your managed care health plan to verify authorization requirements before your appointment.

Mayo Clinic is unable to provide service (except in emergency situations) to Medicaid patients from states other than those listed. A deposit of the estimated charges will be required for services not pre-authorized, or from patients of non-participating states.