Bills and Statements

After your surgery at East Valley Outpatient Surgery, you will receive a statement called an Explanation of Benefits (EOB) from your insurance company.  It itemizes the fees charged and indicates the allowable amount covered by your insurance company.  After receiving the EOB, you will also receive bills from East Valley Outpatient Surgery, your surgeon, and your anesthesiologist for your rendered care.

When you receive the bill from East Valley Outpatient Surgery and are not sure of the charges, call us at 480-739-1658.  We realize medical billing and insurance statements can be difficult to understand and can be very intimidating.  Our billing staff will help you to understand your  statement and will clearly explain how these costs are derived.  Most importantly, we will assist in maximizing your insurance payment to you for your healthcare costs.

FAQS

If I have a question about my bill or how much my procedure at East Valley Outpatient Surgery will be, who should I talk to?

Please call East Valley Outpatient Surgery patient services at: 480-739-1658.

 

When will I be expected to pay the amount that is my responsibility?

You are expected to pay your patient portion on or before the day of surgery. If you will not be able to make the payment at that time, please contact us at 480-739-1658 BEFORE the date of your surgery to discuss your options.

 

Why am I asked to pay on or before the day of service?

In keeping with the terms of your agreement with your insurance company, as well as the agreement between the insurance company and East Valley Outpatient Surgery, we require that you pay the facility fee on or before the date of service.

We do our best to provide you with an estimated facility fee before you receive services. This gives you the opportunity to understand how your health insurance will be applied to the services you receive here.

 

How and where can I pay my bill? What forms of payment are accepted?

You can pay:

  • In person at East Valley Outpatient Surgery (cash, check, credit or debit card)
  • By telephone with a credit or debit card: 480-739-1658
  • By mail by sending your billing statement and payment (check, credit or debit card) to:
    East Valley Outpatient Surgery
    5620 East Broadway Road, Suite 102
    Mesa, Arizona 85206

 

How do you determine patient portion costs?

East Valley Outpatient Surgery is contracted with several insurance companies. These contracts specify how much money your insurance will allow as payable for a procedure. We will assess the insurance contract and your plan benefits to estimate your patient portion. If your insurance is out-of-network at our facility, we will do our best to set your patient portion based on your in-network benefits.

 

What is a “co-pay”?

A co-pay (co-payment) is a set fee that the insured person pays to providers at the time of service. Co-pays are applied to emergency room visits, hospital admissions, outpatient surgeries, office visits, etc.

 

What is a “deductible”?

Deductibles are provisions that require the insured person to pay a specified amount before insurance benefits are provided. For example, if your policy has a $500 deductible, you must accumulate and pay $500 out-of-pocket before your insurance will begin paying a percentage of service charges. Once you have accumulated and paid your deductible to your medical providers, your insurance plan will start paying a percentage of future medical bills. You are thereafter responsible for your coinsurance. Deductibles typically re-set annually.

 

What is “co-insurance”?

Co-insurance is a form of cost sharing. After your deductible has been met, your insurance plan will begin paying a percentage of your bill. After your insurance has processed the claim and paid the percentage determined by your plan benefits, you will owe the remaining percentage, or “co-insurance.”

 

What do the terms “in-network” and “out-of-network” mean?

If you have selected a PPO plan, you will have both in and out of network coverage. Healthcare providers that participate in your health plan are often referred to as “in-network,” and providers that do NOT participate in your health plan may be referred to as “out-of-network.” If East Valley Outpatient Surgery is out-of-network, we will check both your in- and out-of-network benefits and do our best to offer a facility fee that is comparable to an in-network provider.

 

Will East Valley Outpatient Surgery submit claims to my primary and secondary insurance?

As a courtesy to our patients, we submit claims to your primary and secondary insurance companies. We will do everything we can to advance your claim, and will contact you if we need your involvement in the process.

 

What is an “Explanation of Benefits” (EOB)?

An EOB, or Explanation of Benefits, is a letter from your insurance company that provides information about how insurance processed your claim. If you have any questions about your EOB, please call us.

 

What should I do if the insurance company sends payment directly to me?

If you receive a check from your insurance company, please immediately call us at 480-739-1658. We will ask you to endorse the check to East Valley Outpatient Surgery and send it directly to our office. It is very important that you endorse this check immediately to East Valley Outpatient Surgery: it is money due to the facility and is not to be used for any other purpose.

 

Do you balance bill?

No. Our practice does not balance bill. If insurance does not pay the full-billed amount, we will not bill you for what insurance did not pay. You will owe the amount that is discussed with you prior to surgery.

Disclaimer: East Valley Outpatient Surgery strives to provide current account information. However, information can change. Please contact your insurance provider if you have any questions regarding their payment of your accounts.