Health InsuranceIf you are covered by health insurance, please remember that this is a contract between you and the insurance carrier. We will submit all insurance claims for you, including secondary insurance. To ensure proper processing of your claims, it is vital that you supply our office with accurate up-to-date information at the time of your surgery. This includes any necessary patient-completed forms your insurance carrier may require.
- "Usual, Customary and Reasonable" Accounts
Some insurance carriers have established "usual, customary and reasonable" maximum accounts that they deem appropriate for a specific procedure.
These amounts vary with each insurance carrier. Our office will help you with any resubmission of these claims; however, any amount not paid by an insurance carrier is the patient's responsibility. We will require the co-payment to be made prior to the surgery.
- Pre-Authorization/Referral Forms
Some insurance carriers require pre-authorization or referral forms prior to the day of surgery. It is the patient’s responsibility to know whether or not they need to obtain pre-authorization or referral for their surgery. If you are not sure about the need for pre-authorization, please check with your insurance carrier.
Cosmetic Procedures
Since most insurance carriers do not cover "cosmetic" surgical procedures, you will be required to pay in full on the day of surgery. If you are unsure of when a procedure is considered to be cosmetic, please call your insurance carrier regarding your coverage.
Medicare Part B
Mariners Hospital accepts assignments on all Medicare Part B claims. By "accepting assignment," we agree to adjust your charge to Medicare's "approved amount." Medicare will also send the payment directly to our office.
Medicare typically pays a percentage of the approved amount for covered procedures after you have met your annual deductible. You are responsible for your deductible and the remaining 20 percent balance of the facility fee.
If you have a supplemental insurance policy, we will submit any balance to the insurance carrier after we receive the Medicare payments. You do not need to submit anything to your supplemental insurance, nor do you need to send us a copy of your Explanation of Medicare Benefits. Once your supplemental insurance has paid Mariners Hospital, you will be responsible for any remaining balance.
If you do not have a supplemental insurance policy, any deductible and/or co-payment are your responsibility. We will send you a statement of your balance after we receive payment from Medicare.
Physician Fees
You should be aware that you will be receiving a separate bill from your physician and possibly your anesthesiologist and pathologist. Questions regarding your bill from any physician should be directed to their respective billing departments.
Collection Policy
When you register for services at Mariners Hospital, you sign a contract with the hospital that states that you understand it to be your full responsibility to pay for the services rendered by the Center regardless of your type or amount of health insurance. You also consent for us to directly bill your insurance carrier for the covered portion of the charge. We expect that you will meet the payment obligation and pay your bill in full.
- What to Know Before you Arrive
- Preparation Tips before Surgery
- What Happens in the Recovery Room?
- Billing and Insurance Information