The Women's Health Group

Billing & Insurance

The Women’s Health Group will gladly bill your insurance company, as long as we are provided with the necessary information. We seek to provide prompt and accurate service in processing your claims and tending to your other billing needs. Although we make every effort to help you with your insurance questions and benefit information, it is your responsibility to determine your insurance company’s requirements and benefits, as well as obtain prior approval and/or referral. If your question has not been addressed in the following information please call our billing office; we’ll be glad to assist you!

Definitions

Deductible: an out-of-pocket expense that requires you to pay 100% of your medical bills until you have met this amount.

Coinsurance: After a deductible is met, you begin “sharing” the pay with your insurance. It’s usually a percentage of all costs over the deductible.

Copayment: A fee owed to the doctor at each visit.

Q: Are your doctors contracted with my insurance?

A: We are contracted with and submit claims to many insurance companies. We highly recommend contacting your insurance provider to verify your coverage and benefits prior to making an appointment with one of our providers. Some of the commonly held carriers we contract with are as follows: Blue Cross and Blue Shield, Tricare, Medicaid/Healthwave, Medicare, Fiserv, United Health Care, Preferred Health Systems, Preferred Health Benefits, American Healthcare Alliance, Cigna and Aetna. Please note that contracting providers are subject to change without advance notice or cause.

Q: I received a bill from a laboratory other than The Women’s Health Group?

A: The Women’s Health Group has a convenient in-house laboratory where we conduct a wide variety of tests. In cases where our laboratory cannot conduct necessary testing, we refer specimens we’ve collected to a number of highly skilled outside laboratories. These laboratories’ requests for payment are completely independent of our office. Any questions regarding statements/invoices from an independent laboratory should be directed to the originator of the bill.

Q: What forms of payment do you accept?

A: The Women’s Health Group gladly accepts cash, check, money order, Visa, Discover or MasterCard.

Q: How quickly do you submit a claim after my visit, surgery or delivery?

A: We have a team of people devoted to billing out your services in an accurate and timely manner. Our goal is to file the claim within 24 to 72 hours of the date of service. There are, however, factors out of our control which may affect our ability to process these claims within our specified goal.

Q: I found out I am pregnant, but I am not covered by any insurance plan. Can I still be seen at your facility?

A: The Women’s Health Group provides excellent care no matter your insurance scenario. We will guide you through a few steps in order to begin your care. Our OB Patient Liaison is ready to assist you along the way and answer any questions you may have. The first step will take place at your first OB appointment with our nurse. You will need to provide a $400 payment. This amount goes towards the cost of your care and generally covers most of the routine labs taken at this first appointment. After this first appointment, your OB Patient Liaison will assist you in setting up a mutually beneficial monthly payment plan. After the delivery of your baby, The Women’s Health Group is excited to offer a 20% discount on your obstetric care (global charges, in-house labs and sonograms) if your monthly payment plan was maintained consistently every month. Your OB Patient Liaison will guide you through all of the details.

Q: I received a letter from a collection agency regarding my account. How do I make a payment?

A: The Women’s Health Group does use a reputable agency to handle any accounts that have gone unpaid for a long period of time. We highly recommend contacting the agency to settle your account as soon as possible. You can reach Midwest Service Bureau at (800)362-0272.

Q: How is pre-notification obtained before my scheduled surgery?

A: Once your surgery is scheduled, our office will contact your insurance company to notify them of your upcoming surgery. This notification is not a guarantee of payment or coverage. It is imperative that you contact your insurance company before surgery to verify coverage and benefits.

Q: Will my insurance company cover fertility services?

A: To determine specific benefits, it is always best to contact your insurance company directly.

Q: I am pregnant, and my insurance is changing. What happens to the billing of the global charge?

A: Please notify your OB Patient Liaison as soon as possible with any changes regarding your insurance plan. At every visit, please offer our front desk your current insurance information. Once your new insurance information is on file, we will then bill out any prenatal care you have received up to the termination date of your initial policy. After delivery, your remaining visits and services will be billed to your new plan.

Q: Since your facility is a “preferred” provider with my insurance plan, I assume that my lab charges will also be covered. Do you submit to other laboratories?

A: Our laboratory technicians make every effort to stay abreast of each insurance company’s requests with regard to processing laboratory claims. If you suspect that your insurance plan requires your labs to be processed through a specific facility, please alert your lab technician. If we are not informed in advance, our lab will most likely process your specimen in our on-site laboratory.

Q: My visits should be paid for by my insurance but I received a bill. Why?

A: Our billing team seeks to provide all of our patients with accurate care of their claims. In order to do this, it is vital that you provide us with current insurance information at every visit. If a decision has been made by your insurance, such as “non-covered service” or “pending information from insured,” we refer the balance to you. If The Women’s Health Group contracts with your insurance company, they have specific standards and procedures that we are required to follow regarding your claims. You may contact our Billing Department with any questions or concerns. Also, it is recommended to contact your carrier to inquire about any unresolved issues. Thank you for keeping us abreast of any changes in your personal and insurance data!