Insurance

You can help ensure an efficient experience by assisting with the following:

  • Providing us with your picture identification, insurance card and Social Security number to enable us to submit your claims timely and accurately
  • Knowing your insurance benefits and limitations
  • Ensuring there is an authorization for our providers to treat you if it is required by your insurance, including
    obtaining a referral
  • Providing us with copies of any pertinent medical records, including tests (MRI/CT/Arthrogram) and x-rays
  • Paying your estimated portion of the charges at the time of service
  • Paying any additional amount owed when due
  • Completing required incident/accident forms within 30 days of date of service
  • Maintaining a current account with Proliance Surgeons at all times
  • Providing us with at least 24 hours advance notice should you need to cancel or reschedule an appointmen

Please note that co-payments, co-insurance and deductibles are a contractual agreement between you and your insurance carrier. We cannot change or negotiate these amounts.

Insured Patients

We will bill your primary and secondary insurance carrier in a timely manner. If you are disputing payment with your insurance carrier or have a balance over $100.00 with us, you must notify our business office and make payment arrangements.

Deductibles/Co-Insurance – A pre-payment of facility fees is required for all elective, non-emergent procedures prior to the surgery being performed. Your out-of-pocket cost is estimated based on your benefits and our fees. Anesthesia and other providers are separate fees.

Non-Participating Insurance – If we do not participate in the insurance you have, we will file a claim as a courtesy. All unpaid claims will become your responsibility 45 days following filing and be immediately due and payable.

Uninsured Patients

For uninsured patients, we offer a 20% discount when charges are paid before or on the day of service. This discount does not apply in cases of cosmetic procedures, motor vehicle accidents, third party insurance claims or in other cases when the patient may be reimbursed in full.

Private pay patients who receive retroactive Medicaid coverage need to immediately notify our business office.