Billing and Payment Information
BEFORE THE DAY OF SURGERY
Patients with Insurance Coverage
It is the responsibility of the patient to ensure that the ASCW has been provided with the patient’s current insurance information. This will save both the patient and the ASCW many hassles.
After your case is scheduled at the ASCW, an ASCW financial coordinator will:
Contact your insurance company to verify your benefits and to obtain an estimate of reimbursement to the ASCW and an estimate of the amount you owe (deductible, coinsurance and/or copayment) to the ASCW.
Contact you, the patient, via telephone to review the information provided by your insurance company and to confirm the amount of money (deductible, coinsurance and/or copayment) you must pay to the ASCW.
- payments greater than $500 that will be paid by cash, personal check, bank check or credit card must be paid at least 5 business days before the date of surgery
- payments $500 or less that will be paid by cash, personal check, bank check or credit card may be paid upon registration on the day of surgery.
For your convenience, the ASCW accepts VISA, MasterCard, American Express, Discover and your bank debit card.
Please be aware that:
- estimates provided by your insurance company are based on the planned procedure and are not a guarantee of payment.
- the ASCW billing staff will bill your insurance company first.
- the ASCW billing staff will work closely with you and your insurance company to ensure prompt payment.
- regardless of insurance coverage, the patient is responsible for the timely resolution of the account balance.
Patients without Insurance Coverage
If a patient does not have insurance, or the procedure is not covered by the patient’s insurance carrier, the patient may be required to prepay for services.
On the Day of Surgery
The patient must fulfill his/her financial obligation to the ASCW upon registration* at the ASCW. Payments on the day of surgery must be cash, bank check or credit card.
The patient’s surgery may be canceled if the patient’s financial obligation is not paid-in-full upon registration.
*Patients with Blue Cross Blue Shield must pay their copayment upon registration on the day of surgery; however, they may choose to pay their coinsurance and/or deductible after the scheduled date of surgery.
After the Day of Surgery
Although the patient’s insurance coverage is verified and estimates are obtained before the day of surgery, the insurance carriers do not guarantee payment. We share your frustration and will work with you and your insurance company to resolve any outstanding issues.
The insurance carrier will send an “Explanation of Benefits” to the patient and to the ASCW when they make a payment to the ASCW. The “Explanation of Benefits” outlines the amount paid to the ASCW and the amount that the patient owes to the ASCW.
Patients should be aware that the “Explanation of Benefits” may not match the pre-verification estimates for various reasons. Most commonly,
An additional portion of the patient’s deductible may have been met between the time of pre-verification and the time the insurance company makes a payment to the ASCW. In this case, the patient may have “overpaid” his/her deductible. The ASCW will refund the patient any overpayment made. The estimate was based on the planned surgical procedure and the actual surgical procedure may be different.
After your insurance carrier has paid the ASCW, you will be billed by the ASCW for the remaining balance.
On occasion, the insurance company may request additional information from the surgeon or patient. If the information is not provided, the insurance company may not make a payment to the ASCW. In this case, the ASCW will then bill the patient.
Please be aware that the patient is ultimately responsible to pay for the services rendered at the ASCW.
Insurance companies may have a specific time period in which a patient may dispute the claim. Please be aware that we may not be able to assist you effectively if you do not dispute the claim within the specified time period. The time period may be different with each insurance company so please review your options carefully.
We understand that there are circumstances that may warrant an extended payment plan. We are open to working with anyone known to us needing medical services and facing financial hardship. Patients with financial hardships must complete an application to be considered for an extended payment plan. They will be asked to provide documentation of their financial hardship.
If you have any question about an ASCW bill, please call (914) 244-6755.