Surgery charges can vary greatly from $500 to $100,000 based on the complexity of the procedure. Deductibles and co-insurance will need to be paid prior to surgery. Please discuss any questions or concerns with our billing staff. We will make every effort to work with you on payment.
Please be prepared to pay for your visit at the time of the visit. Please do not use $100 and $50 bills as we do not keep large amounts of cash on hand.
Insurance and HMOs
We will file your insurance for the balance of the charge. Please bring with you all your health insurance cards and complete the patient questionnaire as accurately as possible. For your insurance to process the claim for payment, it is essential for us to have complete and accurate information. We realize the insurance process can be challenging and we will make every effort to contact the carrier and follow up on claims in an effort to get these paid. Ultimately, the insurance is yours and often times it may be necessary for you to be involved in resolving conflicts or additional information requested from the insurance. If you receive any correspondence from the insurance company, please respond in a timely manner. If you have any questions, often our experienced insurance and billing staff can assist you with an answer.
If you are a patient under an HMO or any plan requiring a referral number, you must bring that with you at the time of your visit. If we do not have this number, your appointment will have to be rescheduled. This presents an inconvenience for you and us. Please follow up on your referral number with your primary care physician.
Our office participates with many insurance companies. Please, always call your insurance company and ask them if our physicians are on the list of participating physicians. With the many changing companies and networks, we cannot guarantee you of our participation with any plan. Please call and clarify if our office is considered in-network or a participating provider before you are seen in the office. We will see you as an out of network provider which will result in higher co-pays and deductibles for you or complete responsibility for the entire bill. Some insurance companies provide zero out of network benefits and the entire bill is your responsibility. We realize the networks and insurance coverage and benefits are very challenging and frustrating and our insurance department will be glad to offer assistance or guidance as you go thru this process.
If you have an injury while at work and are seeing us as a result of that injury, we will need to utilize workmen’s compensation insurance for our services. All workmen’s compensation patients, for a first time visit, must have the case manager or adjuster schedule the appointment. We must have the name and numbers for the case manager/adjuster and the type of visit authorized as well as how many visits are authorized. Without authorization, appointments must be rescheduled. For workmen’s compensation visits, all services provided or requested must be authorized by the adjuster or case manager assigned to your care. It is common for the case manager/adjuster to accompany the patient to the appointment.
If you have been involved in an automobile accident, you must notify your auto insurance carrier that you were injured. All automobile accidents must utilize your automobile insurance benefits for payment until these benefits have exhausted the dollar amount of your coverage. Once the auto coverage has been exhausted, your health insurance will take over for coverage and payment of your medical expenses (the auto insurance will send a letter which must be forwarded to the health insurance carrier before they will pay claims). We require your automobile insurance identification card, the claim number assigned to your accident and all of your active health insurance identification cards for your first appointment. As with all services, any deductibles or co-pays must be paid by the patient at the time we provide service to you. In regards to auto accidents, we do not accept or file third party liability or accept an attorney’s letter. Third party liability involves you using someone else’s insurance to pay your medical claims.
Please take advantage of discussing the insurance, coverage and payment of your services with our patient account representative in our billing and insurance department. They can be extremely helpful to you. Many of our patients present to us for care for the first time as a result of an accident of some type which is different than seeking medical care for typical diseases. Our specialist is accustomed to the “rules” of the insurance companies for payment of claims. Please discuss your questions or concerns with us. We have a wealth of knowledge and we will gladly share it with you. In terms of whether we are a participating provider- we will always advise you to contact your insurance carrier for verification.
If you have an outstanding bill with our office, please make an effort to work out payment arrangements with us by contacting our insurance department.