PRIOR TO SURGERY
Greater Dayton Surgery Center staff will make every attempt to provide each patient with a good faith estimate of their individual patient responsibility prior to their surgery, while at the same time verifying the patient’s benefits, including any deductibles or copays. Upon receipt or conveyance of the estimate, payment of any deductible or co-insurance owed will be expected prior to surgery.
An insurance claim will be filed on your behalf to any/all applicable insurance providers. Upon reimbursement and receipt of the EOB, the patient’s account will be adjusted accordingly. Should reimbursement take longer than 90 days, Greater Dayton Surgery Center reserves the right to transfer the balance to the patient/guarantor within the guidelines of the contractual agreement.
Any remaining amounts owed to Greater Dayton Surgery Center will be billed to the appropriate party (patient/guarantor). Prompt payment of the remaining amounts is expected.
Once a patient balance is in place (also referred to as “patient responsibility”), our billing department will send a statement to the patient/guarantor. Initial patient balance statements are mailed out at various points during the month, after which they will be on 30-day cycles for any future billing statements until the account has been satisfied (paid to a zero balance or deemed delinquent).
SEPARATE BILLING STATEMENTS
You can expect to receive separate bills related to your surgical procedure(s) and/or course of treatment. These include but are not limited to:
- Physician (OID physician fees)
- Anesthesiologist (Kettering Anesthesia fees)
- Greater Dayton Surgery Center (facility fee)
- Laboratory (if applicable – testing fee)
- Radiology (if applicable – imaging fee)
Greater Dayton Billing department staff members are more than happy to assist you with questions related to your facility statements, and (if possible) will assist with additional billing questions. However, it is recommended that you direct any specific questions to those parties directly. We are not always able to communicate with the various billing departments for each entity, so unfortunately there are questions we will be unable to assist with as it is confidential information relating to your account with those entities.
Greater Dayton staff will attempt to answer any questions that you may have related to the billing process but would also like to remind the patient that insurance benefits are unique to each individual and their associated plan and it is ultimately the patient’s responsibility to fully understand his or her individual benefits.
Your insurance policy is a contract between you and your insurance company or provider. As a courtesy, Greater Dayton Surgery Center will verify your benefits. After verification has occurred, a representative will contact you directly to discuss (if applicable) any payments due prior to surgery. After your procedure, we will attempt to help you receive maximum benefits by promptly filing your claim and supplying any and all applicable information as required by the insurance company for claim(s) processing.
CURRENT AND ACCURATE INSURANCE INFORMATION
Your claim may be affected by many variables. In order for your claim to be filed in a correct and timely manner, we require up-to-date patient and insurance information prior to each visit. This includes current, active insurance card(s), valid photo ID and any other requested documentation. Should your insurance company contact you for further information before or after your claim has been filed, please respond promptly. Any delay in your response may cause a delay and/or denial of your claim.
DIRECT REIMBURSEMENT BY INSURANCE COMPANY
Although infrequent, if your insurance carrier reimburses you directly it is expected that you will contact our office immediately to determine proper processing. In the event the insurance company has not paid your claim within 90 days, you may be held responsible for the timely payment of your account. While we do everything possible to assist in the accurate processing of your claim, Greater Dayton Surgery Center will not become directly involved in disputes between you and your insurance provider.
We accept most insurance plans. Please refer to the list below; if you do not see your plan, or have any questions, please contact your insurance company and/or our Billing department at (937) 535-2200 for assistance.
Accepted In-Network Carriers
Medical Mutual of Ohio
United Health Care
If your insurance carrier is not on this list do not hesitate to call and ask if Greater Dayton Surgery Center has a contract with your provider.
Greater Dayton Surgery Center is proud to contract with the above carriers. We accept these carriers but not all plans within these carriers cover all procedures at Greater Dayton Surgery Center. However, to ensure that your specific plan (as contracted between you and the specified insurance carrier) is accepted, it is imperative that we receive the most up-to-date insurance information. If you have any questions please contact your insurance provider and/or a Greater Dayton Billing team member at (937) 535-2200.
All co-payments must be paid prior to the time of service. The co-pay is (usually) a capped contribution, determined by your insurance contract, payable by the patient each time a medical service is rendered.
If applicable, your estimated deductible and co-insurance information will be provided to you and need to be paid prior to your procedure. A deductible is the amount you must pay out-of-pocket for services prior to your insurance company providing reimbursement. Similarly, co-insurance is an amount agreed upon in your insurance contract which outlines shared responsibility for reimbursement totals, usually comprised of a percentage of the total amount. Sometimes this is affected by your deductible; therefore, it is recommended that you reference your individual insurance policy for the most accurate and up-to-date information.
At times, based on the contractual obligations assigned to you by your insurance carrier and due to various circumstances of the surgical procedure(s), your insurance provider will assign a specific amount as ‘Patient Responsibility’ after your claim has been filed and processed. This can include, but is not limited to, your co-insurance and deductibles and is often calculated based on other medical expenses which have been incurred and filed for pre/post-surgery. This amount is found on each patient’s Explanation of Benefits (EOB). Any assigned balances remaining after your insurance provider has made applicable reimbursement payments are defined as Patient Responsibility.
In order to ensure the best possible patient experience, Greater Dayton Surgery Center will work on your behalf to obtain the most accurate information from your insurance provider(s) and calculate various factors to provide you with the most accurate pre-surgery estimate. It is our intent that this value is as accurate as possible; however, based on circumstances outside of our control this may change. That being said, any amounts provided prior to surgery can only be taken as good faith estimates. Any and all final balances will be billed to you according to our standard billing practices. Should you have any questions related to your estimate, please contact our Billing department at (937) 535-2200.
Many insurance providers require a pre-authorization for surgical procedures. It is the responsibility of your physician’s office to obtain any pre-authorization necessary for your procedure. In conjunction with verifying benefits with your insurance provider(s), we will attempt to coordinate with the physician’s office to ensure (if necessary) that your pre-authorization has been obtained.
At times, the insurance carrier will need additional information from the patient as it pertains to verifying these pre-authorizations. We ask that you be diligent in your response to said carriers as it may affect the scheduling of your surgical procedure.
METHOD OF PAYMENT
For your convenience we accept all major credit/debit cards (Visa, MasterCard, American Express, and Discover), cash (in US dollars), and checks (personal or cashier’s). At this time, Greater Dayton Surgery Center does not currently participate in Care Credit or any other outsourced financing or financial assistance programs.
Full payment of your estimated co-pay, deductible, and/or co-insurance is expected prior to the time of service. In order to provide excellence in care and overall patient satisfaction, Greater Dayton Surgery Center is pleased to offer a variety of payment plans in the event this estimated balance is more than you are able to pay. Please contact our Billing department at (937) 535-2200 for information regarding applicable financial assistance.
At any time, for payment or any other related concerns, it is at the discretion of the Greater Dayton Surgery Center’s Administrator, Surgeon, and/or Leadership to cancel or postpone your scheduled surgery. Please contact our staff if you have any questions.