Billing and Financial Services

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You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost you. You are also protected from surprise billing (also called balance billing). Learn more about balance billing protections. 

It is the policy of MaineHealth to determine the person or entity who is financially responsible for a patient and will receive the bill. Read on to learn more about MaineHealth policies and procedures regarding the determination of guarantor assignment.

What is a Guarantor?

A Guarantor is the person or entity that is financially responsible for the patient’s bill. The Guarantor should always be the patient, or the parent or legal guardian of a minor child, or legal guardian of a dependent adult.

What is a Guarantor account?

A Guarantor account is a record that stores information about a guarantor, such as the Guarantor name, date of birth, address, & coverage. This information ensures that the correct individual receives the bill.

Is the Guarantor the insurance subscriber or policy holder?

The subscriber or policy holder of the health insurance plan is NOT the determining factor in assigning which parent/legal guardian will be listed as the Guarantor.

What types of Guarantor accounts are there and why?

A Guarantor account is a record that stores information about a Guarantor, such as the Guarantor’s name, date of birth, address, and insurance coverage. Every patient needs to have at least one Guarantor account, however; it is possible for one patient to have multiple Guarantor accounts if the services are to be billed to an insurance other than their medical health insurance.

How is the Guarantor determined?

The Guarantor is always the patient, unless the patient is a minor, services are covered by another entity, they are a dependent adult, or ward of the state. A patient presenting for care that is 18 years of age or older is always the Guarantor for bills relating to their care. The Guarantor for a minor child (a child that is under 18 years of age except for an emancipated minor) is the parent/legal guardian that presents the child for care at the time of the initial visit.

Can the Guarantor be changed?

Once a Guarantor account has been linked to a minor child, the Guarantor account is not changed based upon a different parent/legal guardian subsequently presenting with the child for services. However, if the parent/legal guardian provides a divorce decree, order of parental rights and responsibilities, or modifying court order stating that the other parent is financially responsible for the child’s medical bills, the Guarantor is changed to the parent designated within the divorce decree or signed court order. If there is a court order in place clearly identifying which parent is financially responsible for a larger portion of unpaid medical expenses, a copy must be provided to MaineHealth before any changes can be made to the Guarantor listed for a minor child.

In instances when a Guarantor is disputing which parent should be listed as the Guarantor and the financial responsibility for medical expenses is reflected in the court documents as split equally between the parents/legal guardians, moving the child(ren) from one Guarantor account to another can only occur if both parents/legal guardians agree to the change.

What is the process when parents/guardians disagree on who the Guarantor is?

In the event there is no court documentation in place declaring financial responsibility of minor child(ren), MaineHealth would require a notarized letter signed by both parties citing both parties are in agreement to move the child(ren) from one Guarantor account to the other. The letter must include an effective date for the change. MaineHealth’s Single Billing Office Customer Service Team handles all requests for changing of the Guarantors for minor children, including contact information for reminder texts relating to outstanding patient balances.

Who is the Guarantor for an emancipated minor?

When patients who are under 18 years of age have been established by MaineHealth as an emancipated minor, the emancipated minor may give consent for his/her own treatment and medical care. The emancipated minor then becomes his/her own Guarantor.

Who is the Guarantor when a patient aged 18-26 is on a parent’s health insurance?

The law allows children to be covered under their parent’s health insurance policy until that child attains their 26th birthday. The subscriber or policy holder of the health insurance is NOT a determining factor in who the Guarantor is. The child is legally considered their own Guarantor on their 18th birthday.

Facility fees cover the cost of a variety of services you expect when you visit a hospital or a department of a hospital. All MaineHealth locations that are departments of a MaineHealth hospital charge a facility fee. Learn more about facility fees at comparemaine.org.