Pre-certification, pre-authorization and second surgical opinion
Please be aware of your insurance company or employer's pre-authorization and pre-certification requirements and coverage limits before your visit.
Your Mayo Clinic doctor will decide which procedures, tests and other consultations you may need. Pre-certification — determination of medical necessity — is required for some tests and procedures before some health plans will pay for them. Examples of services that may require pre-certification include outpatient and inpatient hospital services, invasive procedures, CT, MRI and PET scans, and colonoscopies. You're responsible for knowing the pre-certification requirements of your health plan.
Prior authorization or predetermination can be initiated by pre-certification staff for procedures that your insurance company considers experimental, elective or cosmetic. This process can take up to eight weeks and often requires pre-certification staff to supply photos and medical-necessity information to your insurance company.
Itemized statement of charges
After you receive care, Mayo Clinic will send you an itemized statement of charges. View a sample itemized statement (PDF). This document isn't a bill. It will provide detailed visit billing information that won't appear on the monthly statement of account. Please retain this information for your records.
The itemized statement of charges includes the following information:
- Itemized list of charges for services at one of Mayo Clinic's facilities
- Identification of and information concerning your insurance company, if applicable
You may see more than one charge for one office visit. This happens because the routine and preventive portion of the visit must be billed separately from the nonroutine and nonpreventive portion.
In some cases, you may receive multiple itemized statements associated with the same visit. You'll receive a separate itemized statement for each facility participating in your care. For example, laboratory and radiology services at the primary care sites may be processed at another facility.
Monthy statement of account
The monthly statement of account will look different from the itemized statement of charges. This is your bill. View sample monthly statement of account (PDF). The billing account number on the statement is the Mayo Clinic number of the person assigned to receive the bill. The billing addressee (guarantor) is the person designated to receive the monthly billing statement listing all patients and visits for which he or she is financially responsible. The itemized statement of charges you receive after each visit will clarify the new charges listed on the monthly statement of account.
The monthly statement of account has these important features:
- Account Activity. This is the summary of new charges and detail of payments and adjustments made on each visit since the previous monthly statement.
- Insurance Claims Pending. This is a summary of the amount under consideration by your insurance company.
- Current Amount Due. This is your total balance minus any amount listed in the Insurance Claims Pending due for services provided at Mayo Clinic's campus in Florida.
Billing questions and answers
How can I make a payment on my account?
For your convenience, Mayo Clinic offers several payment options:
- Discover, MasterCard, American Express and Visa credit or debit cards. Payment can be made at any Registration desk or by calling Patient Account Services at 800-660-4190 (toll-free) to make payment.
- Cash, cashier's check or money order.
- Wire transfers
- Online services. Patients may log in to use Mayo Clinic Patient Online Services, including online bill payment.
- myEasyMatch code. Patients may use the unique myEasyMatch code listed at the top of any printed monthly statement to make a payment online without logging in to Mayo Clinic Patient Online Services.
What if I receive a check from my insurance company?
If your insurance company issues you a check for services rendered at Mayo Clinic and a balance remains on your account, we prefer you deposit the payment into your account and write a personal check payable to Mayo Clinic. Please mail your personal check to Mayo Clinic, P.O. Box 790124, St. Louis, MO 63179-0124.
What if I have a question about my Mayo account?
Patient Account Representatives are available to assist you with the financial aspects of your care. If you don't find the answer to your question in this section, please contact a representative as directed below.
Please call 904-953-6945 to schedule a 30-minute appointment at Mayo Clinic (Davis Building) between the hours of 8 a.m. and 5 p.m. Eastern time.
4500 San Pablo Road
Jacksonville, FL 32224
Attn: PFS Inquiries
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