Billing and Insurance
Thank you for choosing Renal Medicine Associates. We are committed to the success of your medical treatment and care.
Renal Medicine Associates is contracted with many insurances. Renal Medicine Associates and its providers are classified as nephrology “specialists” by your insurance carrier. To ensure that we are in your network, contact your insurance company and verify with them if we are covered.
Our staff will verify your coverage at the time of service. Co-payments are due at every visit. If your carrier has a specific co-payment amount for “specialists”, that is the amount that will be collected by us.
We will bill your health insurance carrier for services rendered by our providers as a courtesy to you. Any balances not paid by your carrier are your responsibility (including deductibles, coinsurance and any unpaid co-payments). A monthly billing statement will be mailed you for any amount that you owe beyond what your insurance carrier has covered.
We accept payments of cash, checks, debit cards, Visa, Master Card and Discover.
You can make your payment in person or by phone. Our phone number is (505) 998-7400. You may also reach out to the billing office to make a payment by any of the methods above by calling (505) 998-7400 and choosing Option #4. Any of the billing staff members can assist you.
If you are unable to pay your balance in full upon receipt of your billing statement, please contact our billing office to discuss your balance and your options on settling your balance. In the event you do not satisfy your account balance in a timely manner, we may elect to send your account to an outside collection agency.
What Is Medicare?
Medicare is health insurance for the following:
• People 65 or older
• People under 65 with certain disabilities
• People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)
The Different Parts of Medicare
The different parts of Medicare help cover specific services:
Medicare Part A (Hospital Insurance)
• Helps cover inpatient care in hospitals, skilled nursing facilities, hospice, and home health care.
• Most people don’t have to pay a premium for Medicare Part A because they or a spouse paid
Medicare taxes while working in the United States. If you don’t automatically get premium-free
Part A, you may still be able to enroll, and pay a premium.
Medicare Part B (Medical Insurance)
• Helps cover doctors’ and other health care providers’ services, outpatient care, durable medical equipment, and home health care.
• Helps cover some preventive services.
• Most people pay up to the standard monthly Medicare Part B premium.
Note: You may want to get coverage that fills gaps in Original Medicare coverage. You can choose to buy a Medicare Supplement Insurance (Medigap) policy from a private company.
Medicare Part C (also known as Medicare Advantage)
• Offers health plan options run by Medicare-approved private insurance companies. Medicare Advantage Plans are a way to get the benefits and services covered under Part A and Part B. Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D).
• Some Medicare Advantage Plans may include extra benefits for an extra cost.
Medicare Part D (Medicare Prescription Drug Coverage)
• Helps cover the cost of prescription drugs
• May help lower your prescription drug costs and help protect against higher costs
• Run by Medicare-approved private insurance companies
• Costs and benefits vary by plan
Medicare End-Stage Renal Disease (ESRD) Program: Patients who have end-stage renal disease, which requires dialysis or kidney transplant, can be eligible for Medicare at any age if they meet certain requirements:
Patients can receive Medicare Part A benefits (Hospital Insurance) at any age if their kidneys no longer work, they need regular dialysis or have had a kidney transplant, and:
They have worked the required amount of time under social security (meaning that they paid Medicare takes for a certain amount of time) (You can call the social security administration to find out how many work credits you have: 1-800-772-1213); or They are getting or are eligible for Social Security or Railroad Retirement benefits; or, They are the spouse or dependent child of a person who fulfills one of the two bullets above.
Just like with traditional Medicare, the patient has a premium and deductible (see Medicare section above) and they must pay 20% of the costs through a retirement/pension plan, private insurance, or out-of-pocket.
Medicare will only cover transplant patients for three years (36 months) after transplant.
Most ESRD patients will sign up for both Parts A and B of Medicare (if you are eligible for A, then you are eligible for B), as many services are not covered under just Part A. You must go to your local social security office to apply for the Medicare ESRD Program. You can find out where your local office is by calling this toll-free number: 1-800-772-1213
Note: Help is available. If you have limited income and resources, you may qualify for help paying your Medicare health care and/or prescription drug coverage costs. For more information, visit www.socialsecurity.gov call Social Security at 1-800-772-1213, or apply for help at your State Medical Assistance (Medicaid) office. If you have questions about Medicare, visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Information Partners Can Use on: CENTERS FOR MEDICARE & MEDICAID SERVICES
What Is Medicaid?
Medicaid is health coverage available to certain people and families who have limited income and resources. The rules for counting your income and resources (like bank accounts or other items that can be sold for cash) depend on which state you live in. Eligibility may also depend on how old you are and whether you’re pregnant, whether you’re blind or have other disabilities, and whether you’re a U.S. citizen. Certain legal immigrants may also be eligible. If a woman’s labor and delivery of her child is covered by Medicaid, her baby may be covered for up to 1 year without needing to apply. Even if you aren’t sure whether you qualify, if your income is limited, and if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworkers in your state look at your situation. People with Medicaid who are disabled or elderly may also get coverage for services such as nursing home care or home and community-based services. Depending on your state’s rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services. If you qualify for both Medicare and Medicaid, most of your health care costs will be covered, including prescription drug coverage.
If you have questions about Medicaid (to find out if you qualify or to sign up), you can call your State Medical Assistance (Medicaid) office for more information. Visit www.medicare.gov/contacts or call 1-800-MEDICARE (1-800-633-4227) to get the telephone number. TTY users should call 1-877-486-2048.