Our Financial & Billing Policies
The number of insurance carriers and possible plans in place today are in the hundreds. The insurance carriers’ rules and policies change on a daily basis. We try to keep up to date on the major plans, however it is impossible for our staff to know the details of each and every insurance plan we encounter.
We encourage our patients to learn everything they can about their insurance policies. The best way to avoid surprise bills, is to be pro-active and prevent them before they occur! We do not routinely confirm coverage after the initial confirmation for each office call. If you have questions, you must call your insurance company.
As a patient, you are responsible to pay in full all charges owed to Center for Weight Loss Surgery, P.L.L.C. (“CWLS”) for treatment, services, and supplies provided to you. Payment in full is due within 30 days upon receipt of our statement for services rendered. As a courtesy to you, CWLS will bill your insurance company, health maintenance organization or managed care company (“your health plan”) for the medical services and supplies we provide to you. However, Medical Insurance is a contract between you and your insurance company. You are ultimately responsible for any unpaid balance.
We are not a finance company and are unable, by law, to extend credit. However, if you need financing options Click here.
At this time, CWLS has opted out of participation in Medicare.
Deductibles and Co-payments
All deductibles and co-payments required by your health plan are your responsibility. CWLS is prohibited by law from waiving deductibles and co-payments. Payment of co-payments are due at the time of service. If we must bill you for co-payments, a $20.00 service fee will be added to the bill to cover the cost of billing and processing.
CWLS’s efforts to bill and collect on your behalf from your health plan and CWLS’s acceptance of payment from your health plan will not relieve you of your obligation to make payment to CWLS in full. The amount your health plan pays CWLS may be less than the full charges or the amount you owe to CWLS. CWLS will credit all payments received from your health plan to your account and will bill you for the balance, unless otherwise provided under Washington law or if CWLS contracts with your health plan to accept the amount paid by them as payment in full.
If you are requested to make an advance payment to CWLS at any time due to the terms of your health plan or CWLS’s patient financial management policies, CWLS will apply this payment to your account and bill you for any balance due. If we bill a health plan on your behalf and receive payment, we will credit the payment to your account and send you a statement reflecting the balance due. If at the conclusion of our services there is a credit balance on your account, we will refund the balance to you. Refund processing takes 30-60 days from the service conclusion date.
Prompt Pay Discount
CWLS provides a prompt pay discount. In general, if a patient pays all charges prior to and including the day of service, a Prompt Pay Discount is available and will be applied. Please contact us for more information on the current discount rates.
Transitioning from Self-pay to Insurance Pay
If you are currently a self-pay patient and want to transition billing to your insurance for services rendered by our providers it is your responsibility to verify insurance coverage for all services prior to our office implementing the change. Patients that make payments for the services at the time of visit receive a prompt pay discount. Note: charges sent to insurance companies are not eligible for prompt pay discounts. If your insurance company denies the charges the new, full balance will be the patient’s responsibility. Once the payment type has transition to insurance-billed, the Center for Weight Loss Surgery (CWLS) cannot retroactively re-bill the charges to the prompt pay discount rates if insurance denies payment. CWLS will continue to bill your insurance companies until we are notified in writing (CWLS form “Insurance to Self-pay") to transition the patient to self-pay billing status.
Missed or Cancelled Appointments
We require at least 24 hour notice if you cannot keep your appointment. Patients will be charged a fee of $25.00 for missed appointments or appointments cancelled with less than 24 hour notice. Your insurance company will not pay for missed appointments. This fee will be your responsibility and must be paid in full before we can schedule additional appointments.
The service fee for returned checks from our office is $30.00. This does not include any charges you may receive from your financial institution.
Service Fees Summary
The following service fees may apply. Fees are cumulative.
||Cancelled or Missed appointment service fee: $25.00 US
||Non-sufficient funds (NSF) check fee: $30.00 US
||Co-payment billing fee: $20.00 US