We understand that having a surgical procedure can be a stressful event with many considerations to make and questions about the billing and payment for services. The following information will hopefully answer some of these questions for you. Please do not hesitate to call our Business Office should you have any further questions.
We know that healthcare insurance can be confusing. Please take a brief moment to review this page to help you understand some key points about your insurance as it relates to your procedure at SouthPark Surgery Center.
- A representative from the SouthPark Surgery Center will contact you prior to the day of your procedure to give you an estimate of your personal portion of the cost of the procedure. This estimate is based on the procedure(s) your physician has scheduled and the type of insurance plan you have.
- Payment of co-pays, coinsurance and any deductible (a description of each is as follows) are due approximately three days prior to your procedure. The representative from SouthPark Surgery Center can take your payment over the phone, in person or assist you with setting up credit options through Care Credit.
- Co-Pay – a form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is responsible for the rest of the reimbursement. There may be separate co-payments for different services. Some plans require that a deductible first be met for some specific services before a co-payment applies.
- Deductible – a fixed dollar amount during the benefit period (usually a year) that an insured person pays before the insurer starts to make payments for covered medical services. Plans may have both individual and family deductibles. Some plans may have separate deductibles for specific services. For example, a plan may have a hospitalization deductible per admission. Deductibles may differ if services are received from an approved provider or if received from providers not on the approved list.
- Coinsurance – the amount due by the patient after the insurance has paid and applied all deductibles and co-pays. This is the amount that is usually described as “Patient Responsibility” or “Member responsibility” on the Explanation of Benefits. It is usually a percentage of the allowed amount covered by your insurance (i.e. 80/20; 70/30; 90/10). We will do our best to determine your coinsurance in advance based on the information received by your physician’s office at the time of scheduling.
- It is important to know that this is only an estimate. Sometimes the surgeon needs to do more or maybe even less during the procedure than what is originally scheduled. These changes may affect your final financial responsibility to SouthPark Surgery Center. Once the claim has been processed by your insurance, you may receive a bill for the balance due or a refund if you have overpaid us.
Because there are several healthcare practitioners who are providing a service to you, there will be separate bills generated from each of these providers; therefore, you can plan to expect bills from multiple providers for one procedure at our Surgery Center.
- Our bill is from SouthPark Surgery Center, which is the facility fee.
- Your physician’s bill will be from Charlotte Eye Ear Nose & Throat Associates, P.A.
- Your Anesthesiologist’s bill will be from Providence Anesthesiology Consultants.
- You will also receive a bill from NMG SouthPark Services, LLC for your Certified Registered Nurse Anesthetist or CRNA.
- If pathology is necessary, you will also receive a separate bill from the pathologist.
As a courtesy to you, the SouthPark Surgery Center will bill your procedure to your insurance company and to a second insurance provider if you have one.
Ultimately, you are responsible for the charges associated with your procedure.
Please call us at the numbers above if you have any questions. Thank you.
Patients are required to pay 100% of their deductibles and out of pocket expenses prior to having a non-emergent procedure or surgery performed in order to ensure that SPSC will receive prompt payment for services not covered by insurance. Each patient will be informed of their benefits and notified of amounts due prior to surgery. If the patient is unable to be reached, payment arrangements will be made on the day of surgery.
Collecting of Pre-Payments
Surgeries Scheduled at the ASC
When surgery is scheduled at SPSC:
- Precertification department will utilize the eligibility tool to verify active insurance coverage for all surgical/ procedure patients.
- The Financial Counselor will notify patients of the deductible and estimated out of pocket expenses that will be incurred for the scheduled procedures.
- All efforts will be made to collect deductibles and estimated out of pocket expenses at least five (5) business days prior to the scheduled procedure or surgery.
- Non-Covered Cosmetic Procedures
- All efforts will be made to collect full amount prior to scheduled procedure.
- 100% of cost of goods: i.e., premium IOL’s – all efforts will be made to collect full amount prior to scheduled procedure.
Elective Surgical Patients
Elective surgical patients who are unable to pay the deductible and estimated out of pocket expenses prior to surgery will be given the following options:
- Payment of 75% of the deductible and estimated out of pocket expenses prior to surgery with the remainder to be paid over 90 days. If outstanding balance remains after 90 days after the date of service, collection process will begin.
- If unable to pay 75%, then 50% of deductible and estimated out of pocket expenses will be collected prior to surgery with the balance paid within 90 days.
- If unable to pay 50% prior to surgery, the procedure will be delayed until required payment is made unless approved by the Administrator or the Business Office Manager.
- Referral to outside agencies for assistance when possible, i.e., Care Credit
Urgent Surgical Patients
Urgent surgical patients who are unable to pay the out of pocket expense will be given the following options:
- Payment of 50% of the deductible and estimated out of pocket expenses prior to surgery with the remainder to be paid over 90 days. If outstanding balances remain 90 days after date of service, collections process will begin.
- Referral to outsides agencies for assistance when possible.
Application of Pre-collection Money
Pre-collection money is applied to the patient’s account in the following manner:
If a surgeon is to waive his/her bill, the patient will be educated the patient will still receive bills from the Facility, Anesthesia, CRNA, and possible lab or pathology for services rendered.