Our practice accepts many different insurance plans. Please call our office to verify coverage before your first appointment or if your insurance plans change.
We have Financial Counselors on staff who will verify your insurance prior to each visit/service and obtain insurance authorization when necessary. Additionally, they will explain your benefits, co-pays, and co-insurance costs, answer questions about balances, and assist you in finding resources for your medications.
Please remember that some insurance plans can take up to 10-14 business days to authorize tests or drug regimens. So be sure to inform us of any insurance changes as soon as possible to avoid delays in treatment and visits.
Insurance Terms
Co-payment:
A defined flat dollar amount paid out of pocket for medical services. This payment is usually due at the time the service is received. Co-payments or co-pays usually apply to physician office visits, prescriptions, and emergency or hospital services. Co-pays are typically associated with HMO (health maintenance organization) plans and in-network POS (point of service plans) services.
Co-insurance:
Co-insurance, like co-payments, is a common form of patient financial responsibility. The amount due is typically calculated as a percentage of charges a health plan will pay. Most often, patients will owe co-insurance after the deductible requirements are met. In addition, co-insurance amounts are lower when services are received from an in-network provider than from an out-of-network provider. Co-insurances are usually associated with PPO (preferred provider organization) plans and out-of-network benefits under POS plans.
Deductible:
The amount of medical expense a person must pay each year from their pocket before the health plan will make payment. The deductible can be a separate amount for medical services and prescription services.
Insurance Benefits:
Most insurance plans include coverage for In-Network and Out-of-Network benefits.
In Network Benefit:
Preferred providers are contracted with a health insurance company to provide services for their policyholders at pre-negotiated rates. With an in-network health insurance plan, the providers are paid for their services at contracted rates. The providers cannot bill the patient for the difference between what the provider bills for their services and what the insurance company is contracted to pay them.
Out-of-Network Benefit:
Out-of-network providers are not contracted with the health insurance plan. Patients can choose a physician in or out of the service area who does not belong to the insurance company’s network. Out-of-network benefits usually come with a higher deductible and a higher co-insurance percentage. Additionally, since out-of-network providers do not have a contract with a health insurance provider, they can choose not to accept the amount your insurance company will pay for healthcare services. As a result, patients could be required to pay the difference between the out-of-network providers' bill for their services and what the insurance company will pay. This practice is called balance billing.
Filing Your Insurance Claims:
We will file your insurance claims on your behalf and help you with questions or concerns regarding the payment of your bill. You may want to have a family member help you. Our staff will provide you with a form so that we can release financial information to that person.
Our practice only bills you for the services we provide in our office. You may be billed separately for laboratory tests, imaging, etc.
We recognize that a cancer diagnosis often causes financial stress for our patients. Please talk with your healthcare team or Financial Counselor if you are having difficulties. Together, we will work towards resolving problems and avoiding disruptions in your treatment.
Please call our office to confirm that your insurance is accepted.
