Questions About Billing

Newport Center Surgical is a provider for the following Major Insurance Carriers and most of their subcontracted provider networks.

  • Aetna
  • Anthem Blue Cross of California
  • Blue Shield of California
  • Cigna

Please call our insurance office at (949) 706-6300 if you have any additional questions that are not answered in our frequently asked billing and insurance questions below.

Q
A
Who can I call prior to surgery if I have questions about the estimated financial responsibility I was quoted?
Please call our Insurance Verification/Benefits Department (949) 706-6300. Our representatives will be happy to assist you.

Q
A
Whose responsibility is it to notify me of my benefits?
It is the patient’s responsibility to know his/her benefits and be aware of any authorizations or pre-certifications that maybe required prior to having his/her procedure. As a courtesy our Insurance Benefits Verification Department checks eligibility and benefits for all our patients, but they are limited to the information that is quoted to them by your insurance. If you know of any change in your coverage or change of employment that may affect your coverage it is your responsibility to contact us with this information.

Q
A
Will my insurance cover my surgery?
Coverage varies and exceptions can apply. Please call your insurance company, plan administer, insurance broker or benefits department (Human Resources) of your employer with any questions regarding coverage.

Q
A
Do you accept my insurance company’s payment as payment in full?
Patients are responsible to pay for their deductibles, co-insurance, non-covered services and co-payment amounts as indicated by their insurance company policy prior to or at the time of surgery.

Q
A
When will I know how much I have to pay when I check in for surgery?
We make an effort to contact our patients one week before surgery regarding their financial obligations. As a result, please make sure your doctor’s offices have the most current telephone numbers for you.

Q
A
I have insurance why am I being asked for payment up front?
All patients are required to pay their estimated financial responsibility (co-pay, co-insurance, and/or deductible) on the day of surgery. Your estimated financial responsibility is based on benefits quoted by your insurance and is the portion that your insurance will not reimburse us.

Q
A
I already paid the doctor, why are you asking me for more money?
When having surgery, there are multiple parties involved: surgical facility (Newport Center Surgical), surgeon, anesthesiologist and possibly an assistant. Each of these parties will bill your insurance separately as we are separate, individual companies. Your estimated responsibility, which is based on the scheduled procedure and benefits stated by your individual policy, for the surgical facility is required on the day of your procedure. Should another medical provider submit their claim prior to us and your responsibility is less than what you paid, you will receive a prompt refund.

Q
A
Do I need DME (durable medical equipment - such as cold therapy, braces, etc)? If so, who pays for it?
The surgery center is not responsible for DME. If your surgeon deems DME as appropriate for you, it will be scheduled by his/her office. The DME company used will be a separate company. Depending on your insurance coverage, they may bill your insurance, but you are ultimately responsible for any costs associated with the prescribed DME. Please contact your surgeon's office to find out if it has been prescribed, and if so, through which company. The DME company can inform you of any associated costs. Items such as, crutches, slings, wraps, and post-op shoes however are included in the facility costs.

Q
A
What form of payments do you accept?
We accept cash, personal check, MasterCard, Visa, Discover, money order and cashier's check. Please be advised that if paying by check that we need your driver's license (or other state government issued ID).

Q
A
How can I contact my Insurance?
If you have been requested to contact your insurance to check on the status of your claim you can contact them at the phone number listed on your insurance card.

Q
A
Who can I call if I have questions about my bill?
Please call our Billing Department at (949) 706-0191. Our Patient Account Representatives will be happy to assist you.

Q
A
Can someone other than me call to ask about my account?
Due to HIPAA regulations and privacy practices we are only able to discuss your account with either yourself or your spouse if they are considered to be financially responsible. For minors we can only speak with the parents or legal guardians. To assign another person, please mail or fax to us a signed letter indicating who we can discuss your account with as well as what we can discuss. Our mailing address is Newport Center Surgical - 17 Corporate Plaza Drive, Suite 120 in Newport Beach, CA 92660. Our fax number is (949) 706-6301.

Q
A
Will you bill my Secondary Insurance?
As a courtesy, we will bill your secondary insurance. (Please confirm we have this information prior to receiving services.) Also, please be aware that any amounts paid by your secondary insurance will be applied to your outstanding balance established by your primary insurance and any remaining balance will be considered patient financial responsibility.

Q
A
Will I receive an itemized statement?
You will receive a statement for services rendered. Our billing department can supply you with a detailed itemization of your surgery at your request once services have been provided. Please contact our Billing Department at (949) 706-0191 and our representatives will generate one upon request.

Q
A
When will I receive a statement?
You will receive your first statement as soon as 3 weeks after your procedure. This first statement is just to notify you that we have billed your insurance and to indicate any payments you may have made on the day of surgery. After that, statements go out on a 30-day cycle to keep you informed of the status of your account and any outstanding balance due.

Q
A
I am a Medicare patient why am I receiving a statement?
All patients regardless of type of insurance receive statements at regular intervals to keep them informed of the status of their accounts. We find this useful in helping patients keep abreast of any issues that may occur and getting them resolved quickly. Additionally, if you have Medicare only, patients will usually have some out of pocket responsibility.

Q
A
Does my bill cover the surgeon and anesthesiologist?
No, your bill is solely for the facility charges. Your surgeon and anesthesiologist will bill separately for their services. You would need to contact their offices directly with any billing questions you may have regarding their services.

Q
A
Who else might I receive a bill from?
You will receive separate bills from your surgeon, anesthesiologist, Registered Nurse First Assistant (if one is utilized), pathology company (if specimens are taken) and Durable Medical Equipment provider (if DME is provided by them).

Q
A
Why do I have a balance due when I paid on the day of surgery?
Amounts paid on the day of surgery are ESTIMATES only based on the procedure scheduled and your insurance benefits. Payment received on the day of surgery is never to be considered payment in full. The final amount due cannot be determined until after surgery as implants could have been used, or alternate/additional procedures performed.

Q
A
What does it mean if my account is in appeals? Will I need to make payments while I wait the outcome?
If your account is in appeals it means that your insurance did not pay your claim correctly and we have resubmitted a written appeal to them providing supporting documentation to reprocess the claim. If you have a patient responsibility it will be noted on your statement. After you have met your responsibility your account will be on hold until the appeal is resolved with your insurance (periodic updates will be mailed). Please be aware this can take anywhere from several months to 1-2 years. Once the appeal is processed, if your insurance has assigned any additional patient financial responsibility you will then receive statements for that amount.

Q
A
How can I pay my bill?
You can pay your bill in person at our facility, by mail (via check or by filling out credit card information on the back of your statement), or by phone with your credit card or debit card. We accept cash, personal check, MasterCard, Visa, Discover, money order and cashier’s check. Our mailing address is Newport Center Surgical-17 Corporate Plaza Drive, Suite 120, Newport Beach, CA 92660.