Frequently Asked Questions
Being a ProHealth Patient
Q: What is primary care?
A: Primary care is the care of the whole person. Primary care physicians include internists, family practitioners, and pediatricians. They provide treatment for a wide range of problems and may see patients in their practice sites, the hospital, or in patients’ homes. When specialty care is needed, primary care practitioners coordinate that care. Helping you stay well is one of your primary care physician’s most important objectives.
Q: What benefits does ProHealth Physicians offer patients?
A: If you are a patient of a ProHealth Physicians practice, you can expect to receive the first-rate, individualized medical care you have always received from your personal physician. In addition, ProHealth Physicians:
- Has developed quality standards and processes for healthcare delivery
- Has developed new and improved services including our own laboratory, bone density testing sites, physical therapy, ADHD evaluation and treatment, hearing center, walk-in care, and sleep center.
- Operates on a secure electronic health record system so that we can communicate better with colleagues, hospitals, and labs, and improve the care we give to our patients
- Works with the UConn School of Medicine Division of Primary Care. ProHealth is responsible for the preceptor program, which allows medical students to more closely watch the physician-patient interaction in the office
- Conducts clinical research trials and outcomes projects to test effectiveness of new treatments, measure safety and cost, and to improve the overall health of our patients. Through their ProHealth physician, patients may be able to participate in clinical studies to test state-of-the-art medications for conditions such as sinusitis, bronchitis, hypertension, cardiovascular disease, Lyme disease, diabetes, and arthritis
- Has a streamlined billing and administration process, freeing physicians from paperwork and administrative functions and enabling them to spend more time where they should be—with you, the patient.
Q: When calling my doctor’s office, what information should I have?
A: Please have the following available when contacting your office:
a. For appointments: Insurance information
b. For prescriptions: Name of drug, dosage, instructions, pharmacy phone numbers
Q: What health insurance do you accept?
A: We accept most major health insurance plans.
Q: What services does ProHealth Physicians provide?
A: Our services include:
- Primary & Specialty Care
- Diagnostic & Therapeutic Services
- Management Services
- Other ProHealth Programs
Q: Who can I contact when I have a question about my bill?
A: You can email your billing question(s) online at submit a billing question. For more complex questions and/or responses needing immediate attention, please call us directly at (860) 284–5200 and press “1” at the prompt, or call toll-free at 1-800-268-2055.
Q: How can I make a payment?
A: You can pay your outstanding balance in one of four ways:
- THE EASIEST WAY TO PAY is to pay online!
- Mail the top portion of your statement with credit card information or check made payable to ProHealth Physicians, P.O. Box 150483, Hartford, CT 06115.
- To pay by credit card over the phone, call Customer Service Monday through Friday from 8:00am to 4:30pm at (860) 409-7700 or toll-free in Connecticut at (800) 268-2055.
- Pay by cash, check, or credit card at any ProHealth Physicians office.
Q: What forms of payment does ProHealth Physicians accept?
A: When paying a bill online or by phone, we accept MasterCard, Visa, or Discover. Please have your account number, expiration date, 3-digit security code, billing address, and zip code ready. You can also mail a check or your credit card information with your statement payment stub to ProHealth Physicians, P.O. Box 150483, Hartford, CT 06115. Your doctor’s office will also accept cash, check, MasterCard, Visa, and Discover.
Q: When is my payment expected?
A: Payment is expected upon receipt of a billing statement.
Q: What if I have a question regarding my bill?
A: Call us, email, or send a letter.
Q: Why do you need to know my address, date of birth, and telephone number every time I call?
A: For security and safety reasons, we need to be sure that the caller is the patient/guarantor of the account we are accessing. We also need to verify that we have up-to-date demographic information.
Q: Does ProHealth keep my credit card information on file?
A: No, ProHealth does not keep credit card information on file. We shred any documentation that has your credit card information after your payment is processed. Additionally, credit card or bank account information you save on our secure Online Bill Pay site cannot be accessed by ProHealth employees.
Q: What can I do to help prevent billing errors?
A: At each office visit, you should provide the front office staff your most recent insurance card. In addition, make sure we have your most recent billing address and contact information. Although this may seem like a burden, it is the key to making sure the proper insurance carrier is billed and you receive your statement (if applicable) in a timely manner. In addition, we encourage you to call immediately if you notice a billing error.
Q: How do I obtain an itemization of my charges?
A: Please call Customer Service or send an email to firstname.lastname@example.org.
Q: I think I have a credit balance on my account or my family member’s account, what should I do?
A: Please call Customer Service or send an email to email@example.com. We will review your account and if a refund is due, we will process it promptly.
Q: Why did my insurance carrier deny my claim?
A: There are many reasons why insurance carriers deny a claim. For instance, some insurance carriers cannot identify you as the member. Other times, a service may not be covered due to your benefit plan. Each scenario may be different, so we encourage you to call Customer Service or send an email to firstname.lastname@example.org. A representative will be happy to review your account and explain the details.
Q: Why can’t ProHealth Customer Service Representatives discuss patient medical information?
A: Our Customer Service Representatives are not clinicians. We are focused on the billing of medical claims. We invite you to contact your doctor’s office directly to speak to a clinician about your medical concerns.
Q: Why did I receive a collection letter from ProHealth?
A: You received a collection letter from us as one last attempt to collect an outstanding balance on your account. If we do not receive a payment from you within ten days from the date on the letter, your account will be turned over to our external collection agency. If you are having financial difficulties, we have options for you. Please contact your doctor’s office or Customer Service during normal business hours to discuss your options.
Q: What is HIPAA?
A: HIPAA is defined as:
- Health Insurance Portability and Accountability Act of 1996
- Federal legislation governing privacy and security of individually identifiable health information (IIHI)
- Applies to healthcare providers, health plans, and healthcare clearinghouses (“covered entities”)
Q: What is the purpose of HIPAA?
A: HIPAA was created to:
- Protect and enhance consumer rights
- Improve the efficiency and effectiveness of healthcare delivery
- Improve the quality of healthcare
- Protect the privacy of individually identifiable health information
Q: Who is covered by HIPAA?
A: People covered by HIPAA are as follows:
- Healthcare providers
- Health plans
- Healthcare clearinghouses
- Business associates