We understand that arranging payment for medical services and determining insurance coverage can be confusing and frustrating. We will do our best to verify eligibility and specific coverage. We will fairly and accurately bill your insurance for medical care. Please communicate with us so that we may guide you appropriately.
Verification of surgical benefits is an extended courtesy to the patient. In order to complete this process, we need accurate and complete insurance and demographic information. In the event that any of this information changes, you are responsible for supplying our office with updated information.
Please confirm, by calling the number on the back of your insurance ID card, that the physician you are seeing is ‘In-Network’ as a contracted provider under your plan. If you are part of an HMO, verify with your insurance that the PCP you have on file does not inhibit your ability to ‘direct access’ our physicians without a referral.
Your insurance company will read a disclaimer that verification or pre-certification of benefits is not a guarantee of payment and that all benefits are subject to plan provisions and limitations. If there are pre-existing condition clauses or any pre-qualifiers that limit your policy benefits, you are responsible for any charges that your insurance company denies or refuses to cover. You will also be responsible to pay any portion of contracted fees that insurance does not cover.
Inpatient surgery requires pre-certification prior to admission to the hospital (also some outpatient procedures). Our office will make sure this pre-certification is in place but you may call as well. There may be times when you are admitted without the office staff having knowledge of the admission (weekend or evenings, etc). In an event of such an admission, please have someone from your family call our office on the next business day to inform us.
Please remember we accept and file your insurance as a courtesy. Any disputes about your coverage should be addressed to your insurance carrier.