Insurance and Billing
We know that undergoing any type of surgical procedure is stressful. As such, billing and payment policies can be a bit confusing and overwhelming. We hope that the following information will make things more clear for you. Don’t hesitate to call us if you have any further questions.
Health insurance is a complex matter. Review these key points about your insurance as it relates to the billing process at Greenbrae Surgery Center.
- You will be contacted from one of Greenbrae’s representatives prior to the date of surgery to give you a cost estimate. This is based on your procedure and your insurance plan.
- NOTICE: You will not receive a call if we expect insurance to pay the full amount.
- Please recognize this amount is only an estimate. It is possible that the surgeon will need to do more or less during the procedure, which can affect your financial responsibility. Once we have processed the claim to your insurance you will receive a bill or refund from our billing office.
- Co-pays, co-insurance and deductible amounts are due upon check-in. Understanding these fees ahead of time can make the process simpler.
- A co-pay is a type of medical cost sharing included in some health insurance plans. It requires that a patient pay a fixed amount when service is received. The insurer pays the rest of the fees. Different services may have different co-pays.
- A deductible is a fixed amount that must be paid during a benefit period (usually over the course of a year) before insurance begins paying for services. Plans can have either an individual and family deductible—or both. Some plans have different deductibles for different services. As an example, a plan may include a hospitalization deductible per each admission. Deductibles may be higher or lower if services are received from an in-plan provider or if received from a provider that isn’t on the list.
- Co-insurance is the amount that is usually described as “Patient Responsibility” or “Member Responsibility” on the Explanation of Benefits of an insurance page. It is the amount due after the insurance pays (after deductibles and co-pays.) This is normally a percentage of the amount covered by your insurance (for example, 80/20; 70/30; 90/10). Since we work with dozens of insurance carriers, we will determine your coinsurance amount after we receive information at the time of scheduling.
- Since several healthcare practitioners are providing services, you will get separate bills. Please expect bills from multiple providers for your procedure at our Surgery Center.
- The bill from Greenbrae Surgery Center is the facility fee.
- You will also receive a separate bill from your physician.
- You could also receive another bill from your anesthesiologist.
- If pathology is required, you will receive a bill from the pathologist.
Greenbrae Surgery Center bills the procedure to your insurance company for the facility portion, as well as to secondary insurance if you have it too. It is important to note that you are ultimately the one responsible for the procedure charges.
Don’t hesitate to call our office if you have any questions. Thank you.
Frequently Asked Questions
Does my anesthesiologist contract with my insurance company?
All of our anesthesiologists are contracted to work with the major insurance companies. If you have questions, please give us a call.
How are the facility’s fees determined?
The facility fee covers the cost of the OR, supplies, nurse and other staff as well as recovery room medications. The surgeon and other fees will be billed separately.
What if I don’t have insurance?
We offer a cash discount to patients who do not have insurance.
Who obtains authorization from my insurance company?
Our billing office verifies your insurance coverage for you. We will also see if the procedure scheduled by your surgeon requires authorization. However, you should check with your insurance company before admission to make certain things are covered as you expect.
What if I can’t afford to pay my bill all at once?
Call our business office at 415-925-8900 to discuss our payment plan.
What forms of payment do you accept?
We accept major credit cards including Visa, MasterCard, American Express and Discover as well as checks and cash (please have exact change).
When do I need to pay my bill?
Payment is due upon receipt of bill.February 15, 2014