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FINANCIAL RESPONSIBILITY POLICY
WELCOME
Our goal is to provide you with the highest quality of
health care.
Please take a few moments to read our
financial
responsibility policy.
CHARGES
You will receive a bill from us, separate from and in
addition to any charges from your surgeon and hospital /
surgery center.
Charges for our medical services are based upon the severity,
complexity, and time associated with your procedure and
care.
Regardless of your medical insurance coverage,
our practice relies on you to settle your account. If you do not have insurance, payment arrangements are
available. Please contact one of our representatives at
Anesthesiologists Office Service, Inc. (319) 743-7300 to
make payment arrangements for our physician charges.
INSURANCE
Private/Government Insurance
If we are provided with accurate, detailed information,
we
will file an insurance claim with your private
insurance or
government carrier. However, you are responsible for the
following:
·
Obtaining appropriate referrals, authorizations, or
pre-certifications from your health insurance carrier.
·
Co-payments, deductibles, coinsurance, or services not
covered by contracted carriers. These
amounts will be
billed to you once insurance has processed your claim.
·
For non-contracted insurance carriers, any balance remaining between our charge and the
insurance payment.
·
If the insurance company is unable to process a claim
due to missing information from you, you are responsible
for the bill.
Most health insurance plans establish networks of
contracted healthcare providers. Discounted fee
arrangements and prompt payment guarantees, among other
provisions, are normally part of those contracts.
The following is a listing of insurance plans with which
Linn County Anesthesiologists, P.C. and LCA, P.L.C.
have
contracts:
We contract (participate)
with the following insurance plans:
| Auxiant
FocusHealth |
Medicare |
| Benefits
Management Group |
Midlands Choice |
| Coventry HMO & PPO |
OHARA
Workers Compensation PPO |
| First Health (but
not workers compensation) |
Principal |
| FocusHealth |
Priority Health
Network |
| Health Alliance |
USA Managed Care |
| Interplan |
UnitedHealthcare of the River Valley Inc.
(ONLY), formerly John Deere Health Care |
| John Deere Health
Care |
Wellmark HMO (BlueCross
BlueShield) |
| Medicaid and
Medipass |
Wellmark PPO &
Indemnity (BlueCross
BlueShield) |
We strive to reach agreement and contract with all
insurance carriers. However there are some
insurance companies with which we have not established
contractual arrangements. If you are insured by
one of these carriers, please be aware that your
insurance company may process our charges at a lower
benefit level or
even without any insurance benefits. If possible,
please contact your insurance company prior to your care
to determine if alternate processing is available.
Also be aware that certain insurance carriers choose to
limit their benefits to amounts they determine to be
"Usual and Customary Rate" or "UCR." When this
occurs, you will be held responsible for any difference
between the charged amount and the amount allowed as UCR
by the insurance company. We will assist you
in
any warranted appeal process you wish to undertake with your
insurance carrier. Please contact our billing
office at (319) 743-7300 for assistance.
We do NOT
contract (participate) with the following insurance plans:
| Beech Street |
SouthCare
HealthCare Preferred |
| CCN |
UnitedHealthcare
HMO & PPO |
| PHCS |
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Workers Compensation
Upon receiving workers compensation information from
you, we will file an insurance claim with your
employer.
If your employer denies your claim, we will
file your claim with your health insurance carrier, if
that information
has been provided. Involvement of
legal counsel will not mitigate your responsibility for
your charges. You are ultimately responsible for
assuring payment for your care.
Third Party Liability
Due to unforeseeable delays in our legal system, your
claim may or may not be paid timely by a third-party you
consider responsible for its payment. Initially we will
file your claim with your liability insurance carrier.
If they
do not pay, we will then file with your health
insurance carrier if that information has been
provided. Please remember that you are responsible for
paying for your care.
Unpaid Balances and Uninsured Patients
Payment plans are available for those in need.
MasterCard, Visa and Discover are accepted. Please
contact
one of our representatives at Anesthesiologists
Office Service, Inc. (319) 743-7300 to make payment
arrangements for our physician charges. We utilize
a collection agency to assist us in collecting
overdue balances.
ELECTIVE SURGERIES
Some medical procedures are considered to be elective or
not medically necessary. If your surgeon
determines that your procedure will be considered
elective by your insurance carrier, you will be asked to
prepay for our services as well. Prepayment is
required two weeks in advance of your surgery date.
Failure to prepay will result in the cancellation of
your surgery.
We work closely with your surgeon so as to accurately
forecast the surgical time utilized to determine the
charge for your elective surgery. However, should
the procedure take significantly more or less time than
originally estimated, an additional charge or refund may
result.
Occasionally two procedures will be undertaken in a
single surgical session. If only one portion of
the surgery
is covered by your insurance, a charge will
be submitted to your insurance carrier for only that
portion of the surgical time. The charges
associated with elective portion will need to be
prepaid. Because these surgeries tend to be less
predictable as to the length of time associated with
each portion of the surgery, a refund or additional
billing for the elective portion may be necessary.
You will be billed for any deductible, co-insurance
or
co-payment as well.
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