Revenue Cycle Managment

Billing

The establishment of this department is to ensure all administrative processes and procedures are consistent throughout the KMC patient cycle. This is to include billing and payments, day to day operations, procedures, forms, and paperwork. This office will also handle initial credentialing for new providers, as well as credentialing updates requested by payers.

Charges to patients

Under provisions of federal law, K’ima:w Medical Center (KMC) is required to bill “third party payers” (such as your insurance company, Medicare, Medi-Cal, or other third-party payer) for all direct-care services provided in its clinics to Indian and non-Indian patients, regardless of your eligibility status.  Furthermore, non-Indian patients may be personally responsible for payment of all, part or none of the services performed, depending upon eligibility status for federal and state benefits. Services provided to patients at KMC are considered “direct care” as opposed to “contract care.” Contract care is health services obtained from facilities or specialist outside the clinic and may not be paid for by KMC (See Contract Health Services).

Sliding Fee

In order to serve indigent patients who might not receive necessary medical assistance for purely financial reasons, K’ima:w Medical Center provides reduced fee for service for which the patient will be responsible.  This reduced fee is based on an income driven Sliding Fee Scale, following Federal Poverty Guidelines. For additional billing inquires please visit our billing office Monday thru Friday 8:00 am – 5:00 pm, closed 12:00 pm to 1:00 pm for lunch. (For professional Services only).