Billing Practices
There are many details involved in the process of reimbursement for services, by the patient and/or physician. In order to alleviate confusion in regards to billing, we are providing an explanation of what is needed to complete the billing process.
What We Need:| Your personal insurance card. At each appointment, our reception or registration team will ask for your insurance card. This is to ensure that we are billing your insurance accurately and efficiently. | |
| Verification of your address and date of birth. This is not only to confirm your identity, but your insurance company requires this information for verification purposes as well. | |
| Your current phone number. It is necessary that we verify your current phone number. Most importantly, it is our duty to ensure our physicians may reach you at any time regarding your health care. Additionally, if our Business Office has questions regarding your insurance or a claim, we may contact you and handle the matter over the phone versus taking time out of your day to handle the matter in person. | |
| Subscriber Information. If you receive health benefits through a spouse, partner, or parent, you are receiving benefits thru a subscriber. On each claim, your insurance company requires the following information about the subscriber: date of birth, full name, and your relationship to them. | |
| Copayment. It is our responsibility to your insurance company to collect any copayments at the time of visit. This is a requirement, and may only be deferred if the appointment is an emergency. | |
| Self-pay Deposit. In the event that you are without insurance, it is our policy to collect a deposit before treatment. It is important to note that the total costs of the visit may be more than the deposit collected, and additional payment will be required after the final billing for services are generated. You will receive a statement within 30-45 days after services have been rendered, in which additional payment will be due. |
| You will only receive a statement for services in which there is a remaining balance owed to our facility. We recommend that you maintain a record of your health care by following the Explanation of Benefits that is sent to you by your insurance company. The Explanation of Benefits identifies the financial responsibility of the insurance plan, any negotiated discounts between our facility and the insurance company, and remaining balances owed by the patient. | |
| We do not bill secondary insurance plans. Payment is due upon receipt of our billing statement. If you have additional insurance coverage, you will need to bill them individually. In order to initiate payment from your secondary insurance plan, they will require a copy of the Explanation of Benefits from your primary insurance. Please refer to your insurance plan’s member handbook for direction. Medicare patients should contact their supplemental insurance plan to arrange crossover billing with Medicare. If Medicare status requires updating, the patient must contact Medicare Coordination of Benefits (COB) at 1-800-999-1118. | |
| Unless specifically requested, all payments are applied to the oldest invoices first. This is done in order to avoid any collections activity. You can request payment on a specific invoice by coming in and making payment in person, or by indicating in writing where you would like your payment applied. | |
| It is the patient’s responsibility to understand their health plan benefits. As a courtesy, we will bill your insurance if you supply the necessary information. Unfortunately, it is beyond our abilities to know specific plan information for each patient. This includes what is covered, at what amount, and which providers are covered or are considered to be “in-network”. We recommend that you contact your insurance company prior to receiving any services in order to determine your level of coverage. | |
| Invoices older than 60 days are at risk of Collections Activities. If, in the unfortunate event, your account has balances turned over to collections, we will notify you by mail. We allow a 45-day grace period to complete payment on these balances. Any monies owed after the 45-day grace period will be reported to our Collections Agency and will result in further collections activity. | |
| Missed appointment fee. In the event that you are unable to keep an appointment, Sutter Santa Cruz requires a 24 hour notice of cancellation. A $50.00 charge may be applied to your account for a missed appointment without notice. |
Any billing inquiries may be directed to our Patient Account Representatives at (831) 458-5500. We are available Monday- Friday, 8am- 5:30pm, excluding holidays.