Take time to review the coverage your insurance plan provides
We want to assist you in getting the most from your insurance plan. It’s important to know that each health insurance company has different rules for covering your costs and filing claims. Take time to get an understanding of your insurer’s requirements before you schedule an appointment or medical procedure. Knowing what your plan requires of you can save you money and get your claims paid faster.
The best time to ask about fees is before you receive services. This will help you make choices that are right for you and plan for the costs you will incur. Call the number on your insurance card whenever you plan to receive care. You can find out whether your plan covers those services and locations that are approved.
Most medical plans cover a portion of your healthcare costs – sometimes 70 to 80 percent, depending on the services you will receive. Your plan often will cover those costs after you have paid your annual deductible, which is your portion of your plan’s costs, for the year. This means as a patient with a health insurance plan, you are still likely to pay fees when you receive services. Check the terms of your plan to find the amount of your deductible.
Our staff also will call your insurance company in advance of your procedure to get an estimate of how much you will be asked to pay. Please remember this is just an estimate. The final amount due will be determined after your insurance company processes your claim.
Here are things you should know about coverage and fees:
Precertification: Many insurance companies require that you to contact a representative before a procedure, sometimes even in an emergency. Check your insurance card for special instructions about precertification or preauthorization. If your insurance company requires a preauthorization, we will work with your referring physician to obtain this; however, you, should always verify that the authorization, if required, has been obtained. This will help ensure your claim will be paid in a correct and timely manner.
These guidelines explain how we may process your claims:
Health insurance plans: In most cases, we will bill your primary health insurance company. If we haven’t heard from your insurer after 30 to 45 days, we may ask for your help in contacting a representative. Amounts that are denied, rejected or left unpaid may become your responsibility, depending on your plan type and benefits. Getting preauthorization can help you avoid unexpected costs.
Medicare: We will submit your claim and then bill unpaid amounts through supplemental insurance policies, if you have these. Unpaid balances may become your responsibility, depending on your plans and benefits.
Medicaid: Call in advance to verify coverage. We will bill in accordance with your plan’s policies. If we are not listed as a provider with your Medicaid product, you may be responsible for the balance.
Workers’ compensation: If a bill is related to treatment for an injury or accident at work, we will file a claim with your employer’s workers’ compensation insurance carrier. Get authorization before scheduling services, when possible. Claims that are denied may ultimately become your responsibility.
Options if you are uninsured: For your convenience, we accept most forms of payment, including cash and checks, VISA, MasterCard, American Express and Discover credit cards. Payment plans can sometimes be arranged in accordance with our policy.
Financial assistance for the uninsured and special financial programs: We will work with you to see if you meet requirements for special financial programs.
We are in network with more than 350 providers nationwide. The insurance providers listed below are the most common carriers. Contact us if you do not see your insurance provider listed.
||Medicaid of North Carolina and Virginia
||Mutual of Omaha
|Blue Cross Blue Shield
|Blue Cross Blue Shield and Blue
||One Health Plan of North Carolina
||Primary Physicians Care
|Government Employees Health
|Health Care Savings