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Frequently Asked Questions |
If your question pertains to one of the ones listed below, simply click on that question to take you to the answer. 1. What is a Medicare waiver and when is it signed? 2. How can I tell if my doctor at KGA is contracted with my insurance company? 4. What is the difference between “deductible” and “coinsurance”? 6. Do I have to bring my insurance card to every visit?
According to Centers for Medicare and Medicaid services, the Advance Beneficiary Notice (ABN), is a written notification that must be signed by the patient or guardian prior to the provider rendering a service to a Medicare beneficiary that could potentially be denied/deemed “not medically necessary”. Once a Medicare beneficiary signs the ABN, he or she is legally responsible for the charges if Medicare denies payment for the service.
The physicians of KGA are contracted with hundreds of different insurance carriers and policies. The best way to verify if your doctor is considered an “in-network” provider is to call your insurance company directly and speak with a patient service representative. At that time, a patient can verify the physicians association with their plan and it would be an ideal time for the patient to ask questions regarding his/her individual policy.
Good question. Yes, these signs are correct. Kingsdale Gynecologic Associates, Inc. will not submit a claim to a secondary insurance unless it is a government funded policy like Medicare, Medicaid, or Tricare. If a secondary insurance is in effect through another carrier, the patient must submit to that carrier on his/her behalf. The front desk staff or the billing office will be more than happy to assist the patient and supply and additional information needed to file.
A deductible refers to an annual amount of out-of-pocket expense(s) the subscriber must pay individually and/or per family before benefits are paid by the payer. Coinsurance is the amount of a medical bill for which the beneficiary and/or secondary insurance is fiscally responsible. This amount is represented by a percentage of the billed charges that is specified by the policy plan or, more globally, by the insurance company with whom the beneficiary is affiliated.
It is a policy at KGA that all coding discrepancies must be submitted in writing and sent to Kathie Westwick, Financial Counselor at KGA. The financial counselor will contact the physician directly to review the date of service in question. At that time, the physician will review all medical records, diagnosis codes and procedure codes associated with the visit. The patient will be contacted either by letter or phone to discuss outcome of review.
YES!!!! Our front desk representatives will ask to see your current insurance card at each visit. Possessing and presenting your insurance card is the only way to ensure claims are being forwarded to the appropriate payer for processing. For patients that do not have their insurance card at the time of their visit, we do offer other alternatives. Please discuss these options with the representative at the time of your appointment or kindly reschedule your visit.
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