Financial Responsibility FAQs
Financial Responsibility Q & A
Here is some information to help explain your financial responsibility to you. You are expected to pay your financial estimate on the day of your surgery. If you are a self-pay patient and will not be using insurance benefits for your surgery, please see the section entitled, “Self-Pay Patients”.
What forms of payment does North Central Surgical accept?
We have several options available including cash, personal checks, cashiers checks, Visa, MasterCard, American Express, Discover and Care Credit*.
What is covered by the estimate?
The estimate is for the facility charges only. The charges for the surgeon and anesthesiologist are not included in the bill. You may also receive a separate bill for durable medical goods or for testing performed prior to your surgery.
How is the estimate calculated?
The estimate is based on two pieces of information: (1) your specific health insurance benefits, which we obtained by calling your insurance company, and (2) the supplies needed, surgical procedures scheduled and length of time the surgery will take, which is given to us by your surgeon.
Why is it an estimate instead of an exact amount?
Your insurance company will not guarantee your benefits prior to the surgery. Also, the actual surgery may use different supplies or take shorter or longer than expected.
How will I know what my expected upfront financial responsibility will be? Provided that we have all the information we need, we will make every effort to contact you before your surgery with your estimate. Sometimes we are not able to verify your benefits, or the surgery isn’t scheduled with us in advance. We will do our best to give you the closest estimate possible.
What can I do now?
Call your insurance company, and verify your benefits. Be sure to ask for the benefits for the specific procedure that will be performed. Never assume that you know your benefits. You may have different benefits depending on what type of health care service is being performed. The benefits that will be applied at North Central are for Hospital facility surgery benefits.
What if I cannot pay for my surgery?
We expect full payment of your estimate prior to your surgery. However, we can offer help if you need it. Please contact us at 214-365-8189 for additional information.
If your household income is at or below a certain level, you may qualify for charity care. Please be advised that you must contact us in advance of your surgery if you think you may qualify. You will be required to fill out additional paperwork, and bring proof of your financial situation, including but not limited to W-2s for the last three years, paycheck stubs, bank statements, and proof of other expenses. If you do not request assistance prior to your surgery, a hardship may not be approved.
Care Credit is a third party financing company that specializes in financial medical and dental costs. Please contact them directly at (800) 365-8295 or on the web at www.carecredit.com
What if I need a payment plan?
Please let us know before your surgery if you are not able to pay in full. Call us at 214-365-8189 to discuss your options. If you cannot pay in full at the time of your surgery, after a certain amount of time (usually 90 days or more from the date of your first statement), your account may be turned over to a third party collection agency.
What happens if the actual charges are different than the estimate?
After your surgery, we will bill your insurance company for the actual services provided, for the actual supplies and implants used and for the actual length of the surgery. Your insurance company will process the claim according to our contract with them. After they process the claim, they will mail both you and the hospital an Explanation of Benefits, or EOB, explaining how much they reimbursed us and how much your actual responsibility is. If we owe you a refund, we will send you a refund check. Please note refunds can take a few weeks to process. If you owe us more than you paid up front as your estimate, we will mail you a statement to the home address you provided us. If you have questions about your EOB, or a refund or balance owed, call your insurance company or the North Central Surgical Patient Account Line at (214) 365-8373 or (972) 763-3850.
Self-Pay Patients: What if I am a self-pay patient and will not be using insurance benefits to pay for my surgery?
We will provide you with an up-front, self-pay quote which reflects a discount.
What if I pay for my surgery as a self-pay patient and then decide after my surgery that I want to file with my insurance?
We will not file a claim with your insurance company if you accept the self-pay up-front estimate. However, we can provide you with information so that you can file a claim yourself.
Still Have Questions?
Call us! We are here to help.
Financial Questions Before Your Surgery:
Call the Financial Service Office at North Central at (214) 365-8189. We can be reached Monday through Friday, between 9:0 am – 5:30pm
Billing Questions after Your Surgery:
Call the Patient Account Line at North Central at (214) 365-8373 or (214) 365-8171 to speak with a representative in our billing office. We can be reached Monday through Friday, between 8:30am -5:30pm.