Billing & Insurance

General Information

We know patients are most interested in understanding how much they will pay out of pocket for their care. We offer multiple ways patients can obtain an estimate for services at our center.

Our billing staff is available to help you understand your health insurance benefits along with your share of the financial responsibility and give you an estimate for the cost of services we provide.

Our staff will provide an estimate that includes the following:

• The estimated financial responsibility for the procedure/services based on the standard charge for the procedure/services.
• Fees charged by Granger Surgery Center are in addition to your surgeon and/or anesthesia provider fees.
• You may be contacted by a Patient Accounts Representative before your surgery to go over any relevant insurance information and to answer any questions you may have.
• Patients with health insurance will be quoted, upon request, an estimated amount that will be due to the Center based on deductible, co-pay or co-insurance amounts established by their health insurance plan.
• Patients who do not have health insurance will be quoted an estimated amount due to the Center that will include an uninsured discount.
• Charity care/financial assistance is not available through the ambulatory surgery center.

If you do not have insurance or are paying cash for your surgery, you will be asked to submit payment on or before the date of your surgery, unless other arrangements have been made. You may also be asked to sign a financial agreement. Please remember that these arrangements are your responsibility and must be made prior to your surgery.

• If you have verified insurance, you will be asked to pay only your portion (your co-payment and/or deductible) on or before the day of surgery.
• We accept all major credit cards.
• We will bill your insurance provider for you. Any balance that your insurance provider does not cover is your responsibility.
• Hours 8 a.m. - 4:30 p.m., Monday - Friday.

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Your Right to a Good Faith Estimate

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost

A patient may ask for an estimate of the amount he/she will be charged for a non-emergency medical service provided in this facility. The law requires that an estimate be provided within five business days of the request for an estimate for a scheduled, ordered, or referred a nonemergency health care service.

If you don 't have insurance or don 't intend to use insurance to pay for scheduled non-emergency health care services, federal law requires that the facility provide you with an estimate of the expected charges and services at least 1 business day before the scheduled services are to be performed.

• If you are uninsured or not using insurance to pay for your health care services, and receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers or call 1-800-985-3059.

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Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is "balance billing" (sometimes called "surprise billing")?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn't in your health plan's network.

"Out-of-network" describes providers and facilities that haven't signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called "balance billing." This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

"Surprise billing" is an unexpected balance bill. This can happen when you can't control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Certain services at an in-network hospital or ambulatory surgical centerWhen you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan's in-network cost- sharing amount. This applies to anesthesia, pathology, radiology, laboratory, or assistant surgeon services. These providers can't balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at an in-network hospital or ambulatory surgical center, out-of-network providers can't balance bill you, unless you give written consent and give up your protections.

You're never required to give up your protections from balance billing. You also aren't required to get care out- of-network. You can choose a provider or facility in your plan's network.

When balance billing isn't allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
• Your health plan generally must:
  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you've been wrongly billed, you may contact the Indiana Department of Insurance at https://www.in.gov./idoi or (317) 232-8582.

Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.