Billing & Insurance
HEALTH INSURANCE
Advanced Women’s Healthcare accepts most insurance plans, although we may not be "in-network" on all plans. We ask that you make sure Advanced Women’s Healthcare is a participating healthcare provider (in-network) for your insurance plan. Insurance companies are increasingly selling plans that have a narrow network of providers and will not provide benefits if you go “out of network.”
As a courtesy, we will contact your insurance company to verify your benefits, and also bill your insurance for services. Any amounts given to us by your insurance are only quotes and not a guarantee of payment. Differences among insurance policies available to individuals have become increasingly complex over the years, and it has become impossible for our practice to know each specific plan and their limitations.
To avoid unexpected charges, it is your responsibility to know your insurance benefits. Your insurance policy is a contract between you and your insurance company, and we are not able to modify coverage, co-payments or deductibles. You will be financially responsible for any balances not paid by your insurance company.
-
In order to bill your insurance company for services provided, it is critical that we have current insurance information in our records.
-
If you have a deductible there may be a patient balance after the insurance company has paid their portion of the bill. We will bill you for this balance due and request payment be made within 30 days.
-
Your insurance company may request additional information from you before they process claims. Please respond promptly to these requests. Failure to respond to insurance company requests may result in unpaid or denied claims, in which case the patient becomes fully responsible for these charges.
INSURANCE CHANGES
If you have changes in your insurance (a new insurance plan from your employer, a job change with new insurance, or new dependents), please let us know when making your next appointment. Having the correct insurance information is very important so that we may accurately process your claim. Having the correct insurance information in your medical record is also important for our clinical providers to make sure any necessary lab work is sent to the right clinical lab and to make sure any referrals are sent to specialists who accept your insurance.
BILLING INFORMATION
We have developed financial policies that we believe are transparent, fair and patient-friendly. Key components of our financial and billing policies are outlined below:
COPAYMENTS, DEDUCTIBLES, AND CO-INSURANCE:
-
Payments are due at the time of the visit.
-
Many insurance plans require that the patient share in the cost of the visit by paying a copayment, co-insurance and/or having a deductible.
-
AWHC cannot guarantee that all services provided at time of visit will be covered under one copayment.
-
Non-payment of copayments may result in billing charges, collection activity, and discharge from the practice.
ADDITIONAL CHARGES
-
Not all services provided by our office are covered by all plans.
-
Please be aware that if any outside lab or imaging services are required, you may receive a separate bill for those services from the lab or imaging provider.
-
For well care visits, some screenings and lab tests are considered separate billable procedures from the actual well care visit by insurance companies, and may require an additional co-payment or may not be covered by your insurance plan.
-
If a well woman annual visit also includes an acute care problem or issues that are outside the scope of normal preventative care, your insurance company may charge a copay or deductible for these "additional issues."
-
There is a $50 fee for missed appointments, or appointments rescheduled or not cancelled at least 2 business days prior to your appointment time. Appointments can only be modified during normal business hours.
-
If you are scheduled for surgery and cancel within 14 days of the surgery date, your surgery deposit will not be refunded. Surgery deposits are collected at the time of scheduling, and refunded once we have received payment from your insurance company.
PAYMENT
Patients are responsible for paying co-payments, deductibles and co-insurance at time of service. Please remember that we do not set your co-payment amount. Your co-payment is contracted between you and your insurance company, and we are not allowed to waive or reduce co-payments. As a service to you, we will bill any remaining co-insurance, deductible, and non-covered services to you after your insurance has processed your claim. We request payment within 30 days for these charges.
-
We accept payment by cash, VISA, and MasterCard.
RETURNED CHECKS
We have a $25 returned check charge for any checks returned to us by your financial institution as non-paid.
PAST DUE BALANCES AND COLLECTIONS
-
If you have a past-due balance on your account, you may be reminded of this when calling to make an appointment and will be asked to bring this payment with you to your next appointment.
-
For past due accounts over 30 days, there will be a $10 fee added to all accounts every 30 days for past due balances.
-
Past due accounts greater than 90 days are subject to third party action and potential discharge from the practice. In the event that your account must be turned over to collections, a 35% collection fee will be added to your account.
Have Questions or Need Assistance?
Contact Our Billing Department!
Phone: 760-327-7900 - Option 7
Fax: 760-327-7905
CMS OPEN PAYMENTS
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.