There are a few things you can do when preparing for outpatient surgery at Aestique Surgical Center. You may have already received your surgical packet from your doctor’s office. The information here is for your reference. Thank you.
There are a few things you can do when preparing for outpatient surgery at Aestique Surgical Center. You may have already received your surgical packet from your doctor’s office. The information here is for your reference. Thank you.
INSURANCES AND PAYMENT OPTIONS
As with any surgical procedures there are four separate bills that you will expect to see:
For your convenience, we do accept most insurance plans. For out of network costs, copayments or deductibles, we accept all major credit cards including Visa, MasterCard, Discover, American Express and CareCredit. We will bill you any balance due after your insurance company has paid your claim. We do ask that all balances are paid in full within 90 days. If you encounter a problem paying within the 90 days, please contact our office immediately at 724-832-7555 and ask for our ASC Billing department. Please remember that insurance is a contract between you, the patient, and your insurance company. Ultimately you are responsible for payment in full to Aestique Surgical Center, regardless of insurance determination to pay.
Your Rights and Protections Against Surprise Medical Bills
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pockets costs, such as a copayment, coinsurance and/or a deductible. You may have other costs or have to pay the difference between the amount your health plan pays for the items and services and the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facility that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charges for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count towards your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care- like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out of network provider or facility, the most you will have to pay the provider or facility is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most you will have to pay these providers is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balanced billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
Contact the Pennsylvania Insurance Department at www.insurance.pa.gov/nosurprise or by phone at 1-877-881-6388 or TTY/TTD: 717-783-3898 if you have difficulty finding a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
If you believe you’ve been wrongly billed, you may contact the Pennsylvania Insurance Department at www.insurance.pa.gov/nosurprise or by phone at 1-877-881-6388 or TTY/TTD: 717-783-3898. Visit www.insurance.pa.gov/nosurprises for more information about your rights under federal and state law. You may also visit https://www.cms.gov/nosurprises for information from the federal government.
PREPARING FOR SURGERY
Medication/Anesthesia:
CONFIRMING SURGERY TIME
FOR YOUR FAMILY MEMBERS
FREQUENTLY ASKED QUESTIONS: