|
|
|
Billing and Insurance Questions ... Why
am I receiving a bill? Our
first statement is informational only, if you have insurance
coverage.
We just want to let you know that we have billed your
insurance company for the services.
If you do not have insurance coverage then we would expect
payment within 30 days. If
you can’t pay your Why
is my insurance not paying my entire bill?
What do I need to do? We
are contracted with most of the major insurance companies.
When we have a contract, we must take a provider adjustment
since you used a network provider. If the insurance company does not
pay per our contract we will send in an appeal for additional
payment. At this point
you really need to do nothing, unless you would like to call your
insurance company. If we
are not contracted with your insurance company, then the balance on
the account becomes the patients responsibility.
At this point, you need to contact us and make payment
arrangements with our office. If
a non-contracted insurance company pays substantially lower than the
usual rates, we will assist you in getting your account reviewed by
the insurance carrier. Our
experience shows that a large percentage of claims receive
additional consideration by the Insurance Companies after review is
requested by the patient and the provider.
If
I have Primary and Secondary Insurance how does this work? We will file your claim to both insurance companies. First we will file the primary insurance company and when they pay, we will then submit the claim to your secondary carrier with the explanation of benefits from the primary carrier. We would like to have payment from the secondary insurance within 45-60 days of billing them. We try to follow-up with all the different companies, but sometimes we can’t get in touch or get straight answers, so you may be billed for the balance after this time. The patients assistance in calling the Insurance Company for “short pay” or “slow pay” is always appreciated and usually effective in getting claims resolved. Why did you bill my Health Insurance Carrier when this surgery is covered by another liability carrier? We
typically bill the insurance company that is provided to us by the
Hospital admission’s department.
If we billed the wrong carrier please call us so we can
re-issue our bill. It
is not unusual, however, for Health insurance companies to pay and
later receive refunds from a “liability” carrier upon settlement
of a claim. Why
hasn’t my Insurance Company been billed? We
bill using the insurance information provided by the St. John’s
Mercy Medical Center admitting office.
Frequently, we
are provided the wrong insurance information or no insurance
information. Our first statement indicates which carrier we billed.
If you see problems, please contact our office so we may bill
the proper carrier. Do
we make payment arrangements? We
understand that patients may not be able to pay their balances in
full, so we have several employees assigned to making acceptable
payment arrangements with our patients.
Typically, we can set up arrangements over a several month
period. Call our office
and request to talk to an agent regarding this option. Why
am I being charged for an office visit for the Surgical
Prequalification Clinic at St. John’s Mercy Medical Center? The
main purpose of the St. John’s Mercy Medical Center Surgical
Prequalification Clinic is to improve overall preoperative medical
evaluation of all surgical patients.
Quality preoperative medical evaluation and intervention is
tantamount to the prevention of untoward intraoperative and
postoperative events. The
clinic is designed to also increase patient satisfaction by allowing
the patient to have an appointment with an Anesthesiologist several
days preoperatively to discuss their medical and surgical concerns,
discuss their planned anesthetic, to understand their anesthetic
risks and complications and to learn of the postoperative treatment
options. By its design,
the prequalification clinic also is beneficial to the efficiency of
the surgical experience by preventing unnecessary last minute
delays, laboratory tests or medical consultation and possible
cancellation of their procedure. The
experience of the St. John’s Mercy Medical Center Surgical
Prequalification Clinic has demonstrated significant reductions in
the ordering of unnecessary preoperative screening laboratory tests,
chest x-ray and electrocardiograms.
Patients are seen and evaluated prospectively; therefore
laboratory tests are ordered on a truly individual basis rather than
preoperative laboratory routine screens ordered without knowledge of
the patient’s medical history.
The clinic has been strongly supported by the surgical staff
as well as Hospital Administration for its improvement on quality
patient care, increase in surgical schedule efficiency and cost
savings in the ordering of less preoperative laboratory tests. Our
group charges a nominal fee for only patients that are seen in the
clinic. Do
you accept Credit Cards? Yes! We accept MasterCard, Visa and Discover. Call our office and we can process your credit card payment electronically. Contact
Us If You Still Have Questions ... Phone: 636-386-1103 Email: Billing@painmanagementservices.net
|