Our physicians are contracted specialist providers with many preferred and managed care insurance plans. In today’s confusing insurance environment it is critical for you to be educated to the requirements of your particular plan.
Some plans require prior authorization for specific procedures or restrict which outside services (laboratory or x-ray) can be utilized. It is a good idea to review your insurance benefits prior to your visit. If you do not comply with the requirements of your plan, you may be held personally responsible for your bill. Our insurance coordinators are available to assist you in these matters.
We offer courtesy billing for all insurance plans if you provide us with a current copy of your insurance card.
Special Note Regarding Medicare
Our office opted out of the Medicare Program on October 1, 2000. We are unable to submit claims to Medicare, and you may not submit them yourself. Therefore, in most instances, patients with Medicare as their primary insurance will be financially responsible for charges. Please contact our office if there are any questions regarding this Medicare issue.
Your Obstetrical fees are submitted to your insurance company at the time of delivery. Early in your pregnancy, we will determine from your insurance company the anticipated patient responsibility. Our billing staff will send you a review of their benefits findings. All patient responsibility is due in full by the 32nd week of pregnancy. If an overpayment results, this will be promptly refunded to you after delivery.
The OB fee is a “package” which includes most of your prenatal visits, vaginal delivery, hospital rounds during your post-partum stay, and a post-partum office checkup. Laboratory tests, Ultrasound, Non-Stress tests and non-routine office visits will incur additional charges. If you are hospitalized during or after your pregnancy for a non-delivery reason, this may also incur an additional fee. A cesarean delivery carries a higher fee and there is a charge for an assistant surgeon. Circumcision, tubal ligation, amniocentesis, and other non-delivery procedures are billed separately. If you have anesthesia, Overlake Anesthesiologists bills you directly. In addition, Overlake Hospital will bill you for all hospital associated charges.
High Risk/Complex Pregnancies
The fee for your obstetric care may be higher if we determine your pregnancy or delivery to be complex or high risk. Examples include preterm labor, twins or complex medical problems complicating pregnancy.</h4