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- 1)
Will you bill my primary and secondary insurance?
- 2) How will I
know if a service is covered by my insurance?
- 3) Are the physicians
at Northern California Cardiology Associates
(NCCA) contracted with my insurance carrier?
- 4) What does “in-network”
and “out-of-network” mean?
- 5) Do you accept
Medicare Advantage Plans?
- 6) How will I
know if my insurance company has paid my bill?
- 7) What is “coinsurance”?
- 8) When should
I pay my copayment?
- 9) When should
I pay my deductible and/or coinsurance?
- 10) Why do I have
to pay for services that were done in the
beginning
of the year when I have both Medicare and
a secondary insurance?
- 11) Why did I
receive an EOB from my old secondary insurance?
I have Medicare primary and gave you my new
secondary insurance information,
so why was my old secondary insurance billed?
- 12) Can I get
an estimate of the charges that I will be
billed?
- 13) I don’t have
any insurance. Is there any way to reduce
the charges?
- 14)
Can I make payment arrangements?
- 15) Why doesn’t
the billing statement show payments that I
previously made?
- 16) What forms
of payment do you accept?
- 17) Where should
I send my payment?
- 18) I just got
a letter from a collection agency. Why?
- 19) How do I dispute
an error on my bill?
- 20) I live outside
the Sacramento area. Do you have a toll-free
number?
- 1) Will you bill
my primary and secondary insurance?
Yes, we will bill your insurance for you
provided that you have given us complete,
accurate insurance information at the time
of service. You will need to bring your
insurance card(s) and a photo ID on the
day of your visit. Your insurance card contains
the information we need in order to bill
your insurance, so it is important that
your insurance card is valid for the policy
under which you are currently covered. You
should also be aware that it is your responsibility
to provide correct insurance information
at every visit. If the insurance information
that you give us is not current, you will
be responsible for payment of the charges.
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- 2) How will I
know if a service is covered by my insurance?
Many insurance plans cover all or part of
your medical charges, but policies vary
widely on which services an insurance company
will cover. Because policies are often customized,
we do not always know what your policy may
cover. Your policy may also have special
requirements for certain services, such
as pre-certification, pre-authorization,
and/or require a referral from your Primary
Care Physician. If you are not sure what
may be covered under your policy, please
contact your health insurance plan’s customer
service department for benefit verification.
The customer service phone number should
be listed on your insurance card or in your
insurance handbook. Please be aware that
you may be responsible for payment of any
charges that your insurance company does
not cover, so it is advisable to find out
prior to the date of your visit whether
the service will be covered.
Questions to ask your insurance company:
• Am I covered for (service/procedure)?
• What is my benefit maximum?
• What portion am I responsible for?
• Do I need a prior authorization for (service/procedure)?
• Is Northern California Cardiology Associates
or (name of NCCA physician) a participating
provider?
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- 3) Are the physicians at Northern California Cardiology Associates (NCCA) contracted with my insurance carrier?
The physicians at NCCA are participating providers with many insurance carriers including Medicare and Medi-Cal.
To find out if we are contracted with your insurance, please contact your health insurance plan's customer service
department or you may contact us at (916) 561-6818. Please be aware that if we are not contracted with your insurance,
you will be responsible for any portion of the charge that is not paid in full by your insurance.
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- 4) What does "in-network" and "out-of-network" mean?
If you receive your health care services from a physician, hospital,
or other health care provider that participates in your health plan,
this is often referred to as "in-network". Health care providers who
do not contract with or participate in your health plan are considered
"out-of-network". Receiving services from an "out-of-network" provider
may result in a higher portion of the bill that you will be responsible for paying.
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- 5) Do you accept Medicare Advantage Plans?
Yes, we accept patients with Medicare Advantage Plans. We do not have to
contract directly with most of these plans because we are Medicare participating
providers. However, if your plan is through a Health Maintenance Organization (HMO),
you will need to contact our Business Office at (916) 561-6818 to see if we are
contracted with your specific HMO plan.
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- 6) How will I know if my insurance company has paid my bill?
Your insurance company is responsible for sending you an
Explanation of Benefits (EOB) when it pays your bill. The EOB should
tell you how much was paid to the provider and how much you are responsible
for paying, such as copayment, deductible, and coinsurance amounts.
Please contact your insurance company if you need clarification of the
information on the EOB or disagree with the way they have handled the claim.
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- 7) What is "coinsurance"?
This is the percentage of the charge that is not paid by your insurance company.
For example, your policy may cover 80% of the charges. Your coinsurance
(sometimes referred to as "patient portion") is the remaining 20%.
\If you have secondary insurance coverage, the secondary insurance may pay
all or part of the coinsurance amount, depending on the plan. If you do not
have a secondary insurance, you will be responsible for payment of the coinsurance amount.
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- 8) When should I pay my copayment?
Most insurance companies specify that copayments should be paid at the
time the service is provided, so you should be prepared to pay your copayment
amount on the day of your visit. Your insurance card should state the amount
of your copayment. If we do not collect your copayment on the day of your visit,
you will receive a statement (bill) from us requesting this payment.
Please contact your insurance carrier if you have any questions regarding your copayment amount.
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- 9) When should I pay my deductible and/or coinsurance?
After NCCA bills your insurance, the insurance will send us an EOB telling us
the amount they have applied to your deductible and/or coinsurance as well as
any other amounts that you may be responsible for paying such as copayments,
non-covered services, or out-of-network amounts. You should also receive an
EOB with this same information. When we receive this EOB, we will send a statement
(bill) to you requesting payment for your portion of the bill.
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10) Why do I have to pay for services that were done in the beginning of the year when I have both Medicare and a secondary insurance?
This is due to Medicare's annual deductible, which becomes effective on January 1st of every year.
Many secondary insurance policies will not cover the payment for this deductible, so you may be
responsible for payments until your deductible amount has been met. Once your annual deductible
has been met, your insurance carriers should resume their reimbursement for covered services.
Please contact your insurance if you have any questions about this.
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- 11) Why did I receive an EOB from my old secondary insurance? I have Medicare primary and gave you my new secondary insurance information, so why was my old secondary insurance billed?
Medicare sends secondary claims directly to many secondary insurance
plans according to the records that Medicare has on file. You will need
to contact Medicare and give them your new secondary insurance information
so that they can update their records. Meanwhile, we have billed your new
secondary insurance and you should soon receive an EOB from them if you have not already received it.
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- 12) Can I get an estimate of the charges that I will be billed?
Yes, please call our Business Office at (916) 561-6875 and a representative will be happy to help you.
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- 13) I don't have any insurance. Is there any way to reduce the charges?
Yes, we offer a 50% discount on the charge(s) if you can pay the 50% balance in
full on the date of the office visit. For patients who were seen in the hospital,
we offer a 50% discount on the charge(s) if payment in full for the 50% balance is
received within ten days after the date you receive our billing statement.
Please contact our Business Office at (916) 561-6875 to inquire about this option.
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- 14) Can I make payment arrangements?
We have several payment options available. If you believe you might have difficulty
paying your bill, please call our Business Office at (916) 561-6875 and we will be happy
to work with you to assess your financial situation and set up payment arrangements or
determine whether you might qualify for a fee reduction.
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- 15) Why doesn't the billing statement show payments that I previously made?
Our statements are designed to show only open balances.
However, we will be happy to provide you with an itemized record showing previous
\payments and how they were applied to the charges on your account.
Please contact our Business Office at (916) 561-6818 if you require this information.
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- 16) What forms of payment do you accept?
We accept cash, checks, money orders, Visa, Mastercard, and Discover.
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- 17) Where should I send my payment?
Please mail to:
NCCA Business Office
1010 Hurley Way, Suite 475
Sacramento, CA 95825
To pay by credit card, please call our Business Office at (916) 561-6818.
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- 18) I just got a letter from a collection agency. Why?
As part of our normal billing process, we make several attempts to contact
you about the outstanding balance on your account. We will send two statements,
a final notice, and also attempt to call you prior to turning your account over
to a collection agency. You may receive a notice from a collection agency if,
after repeated attempts to contact you, we have not heard from you or if we receive returned mail.
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- 19) How do I dispute an error on my bill?
You may submit a written dispute to:
NCCA Business Office
1010 Hurley Way, Suite 475
Sacramento, CA 95825
Please include the name of the patient and account number on all correspondence.
You may also call our Business Office between 8:00 am and 5:00 pm, Monday through
Friday, at (916) 561-6818 and a representative will be happy to help you.
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- 20) I live outside the Sacramento area. Do you have a toll-free number?
Yes, the toll-free number for the NCCA Business Office is (800) 757-1343.
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