Please be sure to bring your current insurance cards and a photo ID with you to each visit. We will need to keep current copies in your records.
We accept most insurance plans. Most insurance plans and managed care payers have policies that require co-payment at the time of service. You will be responsible for payment of all co-pays and any outstanding balances at the time of visit. If you are covered under an HMO or other managed care plan (Point of Service or PPO) there may be specific coverage limitations. If services are not covered under your insurance plan you are responsible for payment. You will be required to pay for such services at the time of the visit.
If there is a any question about our participation with your insurance, please contact our office with your insurance information. We will do our best to help you interpret your healthcare benefits and coverage requirements. However, it is your responsibility to understand which services are covered and which are not covered under your plan and if both our physicians and our outpatient facility participate with your insurance. Likewise, it is your responsibility to identify any coverage changes that may be initiated by your employer or managed care plan. If you have any specific questions, we encourage you to contact your insurance company prior to your appointment. Our billing will include doctors professional fees as well as outpatient surgical facility fees.
We would not want anyone to be denied medical care because of financial hardship. If you have difficulties understanding or paying for our services, we encourage you to discuss your problem with our billing office staff.
Please see the insurance and billing policy information below and contact our office if you have any questions.
As a courtesy to you we will bill your insurance carrier if you provide us with complete insurance information. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. If your insurance company has not paid your account within 30 days, the balance will be assessed to you for payment. You should remit payment within 30 days or contact your insurance company to check the status of the claim. Please notify us immediately upon contacting your insurance company or if there is anything we can do to help settle this claim
BILLING PROCEDURES:
We will bill your insurance carrier for you.
You will be asked on your appointment date to pay for services not covered by insurance. This includes deductibles, co-pays, and co-insurance amounts, occasionally office visits and cosmetic procedures. We accept cash, check or credit cards.
Some insurance plans apply separate co-pays for both the office and the outpatient facility. You will be responsible for both.
After 30 days, if insurance has not processed the claim, it will become your responsibility.
PLEASE NOTE:
Medical Assistance:
We are NOT participating with medical assistance programs. These include, but are not limited to: Gateway, MedPlus, UPMC for You, and Unison. In situations where this may be your 2nd insurance, you are responsible for any balance due that is not covered by your primary insurance carrier.
Medicare:
Medicare patients are responsible for paying their annual deductible each year and are responsible for the 20% allowable charges not paid by Medicare thereafter. If you have 2nd coverage, we will also bill this insurance for you. If after 60 days, the 2nd insurance carrier does not cover this portion of the bill, our office will bill you directly.
Home Host Waivers:
Some highmark products require a home host waiver. These policies usually apply to patients who are employees or the spouse of an employee of a medical facility. This means that because the employees facility does not offer a particular service (Mohs surgery), a special waiver must be obtained for you to seek treatment at another medical facility. As a provider, we cannot obtain this waiver, it MUST be initiated by the subscriber. You will need to contact your benefits administrator. Let them know that you require a home host waiver. This process takes several days. It is your responsibility to notify our office once you have received approval. Without this approval your surgery will need to be rescheduled.
If prior authorization or referral is required, please contact your insurance company or your primary care physician at least one week prior to your appointment. Let them know the following:
You are having Mohs Surgery and possible reconstruction, this will be performed in an outpatient Ambulatory Surgical Facility.
