Insurance and Billing

The Surgical Center Billing

Thank you for choosing The Center for Ambulatory Surgery for your procedure.

Due to the number of insurance carriers we may or may not participate with it is imperative that you call and confirm your benefit status with your insurance carrier. Each plan is different and some provide different levels of coverage that could make a difference in your out-of-pocket costs.

Call our billing department before your surgery date at (908) 233-2020 and ask for Patient Billing, Monday thru Friday between the hours of 9 a.m. and 5 p.m.

After identifying the extent of your coverage we can determine your financial responsibility. You will be notified of these financial responsibilities. For your convenience, we accept Master Card, Visa, American Express, Discover, Personal Checks and cash. Payment arrangements need to be made prior to surgery.

Occasionally you may be billed for extra services. An example of those extra services could be an implant that is placed by your surgeon, an unusual medication, etc.

As a service to you we will bill your insurance company first. However, you will be liable for those costs which your insurance company does not cover. We offer discounts for those who do not have insurance.

We offer the option to pay bills online. With our online bill pay option, you can securely make a payment for your service online with no hassles.

Anesthesiologist Billing

You will receive a separate anesthesia bill. The anesthesia services are not included in the Surgical Center fee. The Anesthesia billing department will accommodate the patient by first billing the insurance company. However, any balance that is not covered by the insurance company will have to be met by the patient. There may be certain procedures where the anesthesia fee will be collected in advance. Co-payments, deductibles, etc. may also be collected in advance of the surgery.

Surgeon Billing

The surgeon or surgeons will generate a charge for their services. Please contact your surgeon’s office to discuss any billing matters.

Other Billing

There may be other bills that a patient can incur during surgery. These are ancillary services that may be utilized during your surgery. Examples of this are pathology fees, certain radiology fees and any special devices your surgeon may order for you to take home.

Insurance Cost Estimator

The estimates we provide are only related to your facility bill. Our fees do not include your surgeon, anesthesiologist, pathologist, and radiologist’s fees. Your personal physician or other physicians providing you with services related to your facility stay or visit will bill you separately. These providers may or may not participate in the same health plans as our facility. Please contact them directly to verify they participate in your health plan.

Insurance Plans We Accept

Our surgery center is dedicated to providing consumers with as much information as possible regarding potential healthcare costs. Accordingly, we have listed information on the insurers and providers the center participates in.

It is important you contact your insurance company prior to receiving services or care. Each plan is different and some provide different levels of coverage that could make a difference in your out-of-pocket costs.

In Network

• 1199 SEIU Benefit Fund
• Aetna
• Aetna Medicare
• Amerihealth Tier I & Medigap
• Chn (Listed As Provider On Website)
• Cigna
• Emblem Health (GHI) With Empire BCBS Or Qualcare
• Horizon BCBS
• Humana Medicare Supplement Plan
• Medicare
• Meritain Health
• NY Ship With Empire BCBS Or United Healthcare
• Oscar
• Qualcare
• Samba
• Tricare For Retired Military Only
• UMR
• United Healthcare/Oxford

Out of Network

• Humana Medicare
• Magnacare
• Tricare Reserve Connect
• United Healthcare Aarp Medicare Advantage Hmo
• Wellcare

This list may not be comprehensive. For example, specialty insurers such as workers’ compensation and personal injury protection (“PIP”) are not included because there are a number of different types of insurance products and we may not participate in all of them. If you do not see your plan listed on our website, we strongly recommend that you contact us or your health insurance plan to confirm whether your plan is in-network or out-of-network.

In addition, the physicians who provide care within our center might not participate in the same insurance plans as the ASC. You should check with the physician who is arranging your healthcare services to see which insurance plans the physician participates in. You should also know that these healthcare professional(s)’ costs are not included in the facility’s charges. They will bill separately.

Other Care Providers

We work with other providers as part of your care. In addition to a bill from the facility and the physician, you may receive a bill from another provider, depending on the nature of your procedure.

Anesthesia Group

New Jersey Healthcare Specialists (Envision)
P.O. Box 412138 – Billing Dept.
Boston, MA 02241-2138
Pre-Services Dept.: (888) 610-5651
Billing Dept.: (866) 678-4324

Pathology

Pathology Consultants of New Jersey (AKA Rahway Pathology)
865 Stone Street
Rahway, NJ 07065
Phone: (732) 499-6139
Fax: (732) 499-6139

NJU Diagnostics
1515 Broad Street, Suite B180
Bloomfield, NJ 07003
Phone: (973) 873-7036
Fax: (973) 873-7037

The Cost of Your Procedure

Because you are responsible for costs for covered healthcare services until you reach your deductible, you should comparison shop if you elect to have a nonemergency procedure.

You can use tools like Healthcare Bluebook and the Medicare Procedure Price Lookup (for Medicare patients).  Many health insurance websites also provide information on where to find in-network services.