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Health
Insurance
If you are covered by health insurance, please remember
that this is a contract between yourself and the insurance
carrier. We will submit all insurance claims for you, including
secondary insurance. However, to ensure proper processing
of your claims, it is vital that you supply our office with
accurate and up to date information at the time of your
surgery. This includes any patient-completed forms that
your insurance carrier may require.
"Usual,
Customary & Reasonable" Amounts
Some insurance carriers have established "usual, customary
and reasonable" maximum amounts, which they deem appropriate
payment for specific procedures. These amounts vary with
each carrier. Our office will assist you with initial submission
and any resubmission of claims. However, any amount not
paid by an insurance carrier due to UC&R will ultimately
be the patient's responsibility.
Pre-Authorization/Referral
Forms
Some insurance carriers require pre-authorization or referral
forms prior to the day of surgery. It is the patient's responsibility
to be aware of whether or not they need to obtain pre-authorization
or referral for their surgery. If you are not sure about
the need for pre-authorization or referral, please check
with your insurance carrier. Our scheduling department will
assist you with this process.
Deductibles/Co-pays
You and your insurance carrier may be contacted prior to
the day of surgery to verify your insurance benefits. All
insurance co-pays, remaining deductibles and any outstanding
balances with the Center must be paid prior to the day of
surgery.
Patient
Statements
Spinal Diagnostics and Treatment Center, LLC has adopted
a deferred billing service for our patients. A deferred
billing service allows us to submit a claim on your behalf
to your insurance carrier for payment of services. After
payment is received from your carrier, we will then send
you a patient statement for any uncovered balance. This
deferred billing policy is a service that Spinal Diagnostics
and Treatment Center, LLC is happy to provide to our customers.
Prompt payment is expected in full, upon receipt of the
statement. If you have any questions regarding your bill,
please contact our Business Office at (650) 755-5098. It
is important to communicate with our Business Office, so
that we may help you to understand our billing procedures.
Worker's
Compensation or Accident-Related Claims
Spinal Diagnostics and Treatment Center, LLC cannot accept
responsibility for any disputed claims and holds the patient
responsible for all charges. As a courtesy, our office will
submit an insurance claim to the responsible party's carrier
if all information necessary to submit the claim is given
to us prior to the date of service. If we do not have sufficient
information to submit a claim to the Worker's Compensation
carrier, the bill will be sent to the patient.
Medicare
Part B
Spinal Diagnostics and Treatment Center, LLC accepts assignment
on Medicare Part B claims. By "accepting assignment,"
we agree to adjust your charges to Medicare's "approved
amount." Medicare will also send the payment directly
to our office. Medicare typically pays 80% of the approved
amount for covered procedures after you have met your annual
deductible. You are responsible for your deductible and
the remaining 20% balance of the facility fee. If you have
a supplemental insurance policy, we will submit any balance
to them after we receive the Medicare payment. You do not
need to submit anything to your supplemental insurance,
nor do you need to send us a copy of your Explanation of
Medicare Benefits. Once your supplemental insurance has
paid Spinal Diagnostics and Treatment Center, LLC, you will
be sent a statement and will be responsible for any remaining
balance. If you do not have a supplemental insurance policy,
any deductible and/or co-payment is your responsibility.
We will send you a statement of your balance after we receive
payment from Medicare.
Surgery
Fees
Spinal Diagnostics and Treatment Center, LLC has adopted
a "Global Fee" approach to pricing. This involves
establishing one price for each procedure. We adhere to
that price, regardless of minor variations in supplies or
time units utilized by a patient. This global fee includes
the following: Pre-Op Workup, Admission Unit, Operating
Room, Recovery Room, Discharge Unit and Telephone Follow-Up.
(For more information regarding each individual item, please
refer to the Preoperative Instructions Page). Any procedures
not previously scheduled that your physician deems necessary
at the time of your appointment, (i.e. lab tests not defined,
CT Scan, among others) will be billed to you or your insurance
carrier by the entity that provides the service. You should
also be aware that you will be receiving a separate bill
from your physician. If you have any questions regarding
your bill from Spinal Diagnostics and Treatment Center,
LLC, please call us at (650) 755-5098. Questions regarding
your bill from any other entity should be directed to their
respective billing departments.
Finance
Charges
You can always avoid finance charges by paying your account
in full, within ninety (90 days) of receiving services at
Spinal Diagnostics and Treatment Center, LLC. Finance charges
will be determined by applying a periodic rate of 1.5% per
month (Annual Percentage Rate of 18%) to an outstanding
balance owed. All checks returned for reason of "Non-Sufficient
Funds" will be charged a $25.00 processing fee.
Collection
Policy
When you register for services at Spinal Diagnostics and
Treatment Center, LLC, you sign an agreement with the Center,
which states that you understand it to be your full responsibility
to pay for the services rendered by the Center regardless
of your type or amount of health insurance. You also consent
for us to bill your insurance carrier directly for the covered
portion of the charge. We expect that you will meet this
payment obligation, and pay your bill in full within the
billing date defined in your statement. If it becomes evident
that a patient does not intend to take care of his/her financial
obligation to Spinal Diagnostics and Treatment Center, LLC,
a collection agency may be employed and/or legal action
may be implemented to settle the debt.
Other
Questions
Feel free to call the Center with any other questions you
may have. We will be happy to answer them for you. Our telephone
number is (650) 755-0733. Thank you for your interest in
Spinal Diagnostics and Treatment Center, LLC.
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