FINANCIAL RESPONSIBILITY

 

 

Puyallup Surgical Consultants, a division of Proliance Surgeons, is committed to providing you with the highest quality medical care.


We realize you have a choice for medical care and appreciate your trust in Puyallup Surgical Consultants.

Patients are responsible for the charges associated with care even when insurance benefits are in place. Here are some guidelines to help you navigate the financial aspects of care.

 

 

Patient Responsibilities

The financial aspects of care do not have to be complicated. To ensure the most simple and clear process for your needs please follow these steps:


  • Please provide us with your picture identification, insurance card, and Social Security number so we can submit insurance claims timely and accurately.

  • Please contact your health (or other) insurance provider to learn about your policy benefits and limitations.

  • Please confirm with your insurer that there is an authorization for our providers to treat you, if it is required by your insurance please obtain a referral.

  • Please provide us with copies of any pertinent medical records, including tests; e.g. MRI, CT, Arthrogram, ultrasound and x-rays.  

  • Please pay your estimated portion of the charges prior to the date of service.

  • Please pay any additional amount owed when due.

  • Please complete required incident/accident forms within 30 days of date of service.

  • Please maintain a current account with Proliance Surgeons at all times.

  • Please provide us with at least 24 hours notice should you need to cancel or reschedule an appointment.

 




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.
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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.

 

 


Co-Pays/Deductibles/Co-Insurance


Please be prepared to pay for your portion of the charges on or before the date of service.


Surgery


If surgery is indicated, payment of both doctor and facility fees are required for 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 services from 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.

Most health insurance plans cover surgery. Your coverage depends  on your specific plan.

VIEW ACCEPTED PLANS

Uninsured Patients

Office Visits


A $175.00 deposit is required prior to the appointment. If visits and services are paid in full at the time of service, we offer a 20% discount (see exclusions below). Office visits may include x-rays, casting and materials at an additional charge. Charges are not finalized until chart notes are complete.

 

Motor Vehicle Accidents (MVA)

Insured and Third Party Patients


We do not extend discounts for MVA-insured accidents, third party insurance claims or in other cases when patients may be reimbursed in full. We will bill the MVA insurance carrier one time. The bill becomes your responsibility if not paid by the carrier in 30 days. We regret that we are not in a position to confer with attorneys or defer payment obligations while a case settles. If your personal injury protection benefit on your MVA policy is exhausted, we will bill your private insurance at your request provided we are furnished the necessary information at the date of service.

 

Surgery


If surgery is indicated, payment of both doctor and facility fees are required for 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 services from other providers are separate fees.

 

Workers’ Compensation


If your visit is work-related, we will need the case number and carrier name prior to your visit in order to bill the workers’ compensation insurance carrier. 

If your workers’ compensation claim is not yet accepted and you have no other insurance we require a $175.00 deposit that will be refunded after the claim has been opened.