Billing & Insurance
Thank you for choosing ObGyn Specialists for your medical care. This credit policy is designed to explain our billing practices. Please let us know if you have any questions.
Our physicians and ancillary providers participate in most insurance plans and we will submit claims to these companies on your behalf. Every plan is different, so please check with your insurance carrier if you have specific payment or coverage questions. There is usually a phone number for customer service located on the back of your insurance card.
We ask that you present a copy of your current insurance card at each visit. To provide credit to you, we will also ask that you give us your social security number and present a picture ID. If you are uncomfortable with sharing your social security number, please let one of our front desk staff members know and we will indicate that on your billing account. Your insurance carrier requires that we collect copayments prior to your visit. If you do not pay your copayment at the time of service, a service fee may be added to your account.
If you do not have medical insurance, you will be required to pay for your services on the day of service. We will give you a 20% discount for same day payment. A $175 prepayment is required of all new patients who are covered under an insurance plan with which we are not contracted. This payment is applied to the charges from your first visit. As a courtesy, we will file the insurance claims on your behalf.
Your insurance company determines what amount, if any, you owe ObGyn Specialists, based on the coding from your visit at our office. Once we have filed your visit with your insurance company, we will send you a detailed statement, which is due upon receipt. We accept cash, check, money orders, and all major credit cards. A finance charge of 1.5% per month (18% annually) will accrue on all accounts 60 days and older. A $35 fee will be assessed for all returned checks.
It is important to note that any balance over 60 days old may be placed with a collection agency and/or Credit Bureau. This action may affect your credit rating. Therefore, if for any reason, you are unable to settle your account within 30 days, it is imperative that you contact our business office immediately. Do not assume that any statement you receive will be paid by your insurance company. Call our business office promptly to discuss and correct any issues with your account at our office.
If your account is placed with an outside collection agency, you will be charged the full amount of collection fees, attorney fees, and allowable court costs. Please note that placement with an outside agency will cause us to terminate your care with our office. We make every effort to resolve insurance issues, but please remember that you are ultimately responsible for your healthcare costs.
You may direct all of your billing and insurance concerns to our business office at 952.841.8480
What is the difference between preventive (screening) and diagnostic care?
Preventive care includes immunizations, lab tests, screenings and other services intended to prevent illness or detect problems before you notice any symptoms. The right preventive care at the right time can help you stay well and could even save your life.
Diagnostic medical care involves treating or diagnosing a problem you’re having by monitoring existing problems, checking out new symptoms or following up on abnormal test results. Examples of diagnostic care include:
- STD testing to diagnose a vaginal infection
- Diagnostic mammogram and/or ultrasound to follow up on a breast lump or pain
Why does this matter?
Your insurance coverage may be different depending on which type of services you receive. Many preventive services are covered at 100% at no out of pocket cost to you. Many diagnostic services will come with a charge to you and will go towards your deductible.
How we code these services at our office
All health care providers bill for services using billing codes. These codes tell the insurance company what was done and why. It is not uncommon for patients to become confused between preventative/screening codes and problem/sickness codes—as they can occur in the same visit. While we recommend that you treat your problems and concerns at a visit separate from your annual exam, it may be unavoidable that a portion of your visit will require diagnostic testing.
For example, if a breast lump is discovered at your annual exam, you will be referred for a diagnostic mammogram and ultrasound, even if you are just due for a screening mammogram. Depending upon your insurance, any diagnostic testing may not be covered under your preventative benefits.
If you request STD labs be drawn during your annual exam, those lab services may or may not be considered preventative and will be billed accordingly. Depending upon your insurance company, certain tests are covered within the STD panel, while others are not and are applied to your deductible.
Because many insurance plans cover one preventative exam per calendar year, any other issues will be billed as problems and will then apply to your deductible. It is always best to check with your insurance provider to verify all benefits prior to having testing done.
Billing for pregnancy at our office is set up as a
"global obstetrical package ".Several items are included in this package, but many services are not. Your insurance coverage as well as your deductible and co-insurance will all play a part in your out of pocket costs for prenatal care.
The global package includes routine prenatal visits (7-13), urinalysis, vaginal delivery, and post-partum hospital and office visits. The visits that are not included in the global OB package are, but are not limited to, the procedures listed below.
These procedures are NOT included in global obstetrical package:
- Initial physician office visit
- Hospitalization prior to delivery
- Ultrasound services
- Laboratory services (urine cultures and bloodwork)
- Pap smear
- Non-stress test (NST)
- Non-obstetrical office visits
- Gestational glucose testing
- Cesarean section
- Cord blood collection
- Genetic testing
You will receive a separate billing statement for any of the above services. Please pay these charges within 30 days of receiving the statement. If you have any questions regarding coverage for additional services or hospitalization, please contact your insurance company directly.
If you do not have health insurance, we ask that you pay the global fee and any additional charges in full by your eighth month. We will be happy to bill you in monthly installments for this amount.
You or one of your family members is responsible for notifying your insurance company at the time of your admission to the hospital.
We hope this information will help you prepare and plan for your obstetrical care with our clinic. Please remember that we are here to assist you in any way possible.
Thank you for choosing us to provide your care. If you have billing questions, please call us at 952.841.9480.