About insurance and billing at Princeton Radiation Oncology.
At Princeton Radiation Oncology (PRO), we understand how difficult cancer can be. We also know that cancer treatment can be very expensive, and dealing with medical bills and insurance isn’t easy, even when you’re in the best of health. That’s why we work hard every day to make sure you get the most out of your health insurance and to help you meet the financial challenges. We have a continuing focus on containing costs and following the highest standard of ethics in our billing practices.
Your privacy and protection come first.
We comply with all applicable government laws and regulations. These include the Health Insurance Portability and Accountability Act (HIPAA), which protects your privacy. PRO protects and secures your health information to ensure your information stays confidential.
Helping you get the most from your insurance.
Our caring, knowledgeable team members will help you explore your insurance coverage and learn about your benefits. We’ll help you understand all of your payment options. We’ll also provide contacts for you for many foundations, societies and organizations that work with cancer patients to get financial aid. We understand that every situation is unique, and we’re prepared to work through your individual needs with you.
At PRO, we work with most major insurance carriers. As participation varies by region and physician, we recommend that you contact either our office or your insurance company representative to verify that your insurance plan is accepted. Also, be sure to bring your insurance cards every time you come to the office. And please tell our staff whenever you have a change of insurance.
Learn about deductibles, co-payments and co-insurance.
Out-of-pocket costs—deductibles, co-payments and co-insurance—are important parts of today’s healthcare system. We are required by law to bill you for the costs that your insurance company considers to be your “patient responsibility.” This includes patients who have Medicare.
Make sure you read your insurance plan documents. They can be hard to understand, so take your time and review them carefully. Talk with us if you have questions. You can also talk with your employer or the insurance company’s customer service representative.
Here is some basic but important information about out-of-pocket costs:
- Deductibles – Deductibles are the amount of money you pay before the insurance company starts paying their portion of a medical claim. For example, if your health insurance policy has a $250 deductible, you will have to pay $250 in covered expenses before the company picks up its portion. Usually, higher deductibles mean that you make a lower monthly payment for your premium.
- Co-payments – A co-payment (also called a “co-pay”) is a fixed fee the patient pays to the doctor or medical provider for each visit or service. Co-pays can be $5, $20, $35 or more. The insurance company sets the amount of the fee. You will make co-payments for office visits, emergency room visits, hospital admissions and other medical care.
- Co-insurance – After deductibles are met, the plan begins paying a percentage for your care. Whatever is left over is called “co-insurance.” This amount is paid by the patient.
What does “coordination of benefits” mean?
Sometimes people can be covered under more than one health insurance plan at a time. For example, a person may have Medicare coverage at the same time that their significant other has family coverage from a job. Health insurance companies have set up rules to decide which plan pays first and which plan pays next. This is called “coordination of benefits.”
Here are the basic rules about which plan pays first:
- For your health expenses, your plan pays before your significant other’s plan.
- The plan of the covered person who has the earliest birthday in the year pays first on children.
- If two insurance companies don’t agree on who pays first, the coverage that has been in effect the longest pays first.
Important billing information to be aware of.
You will receive a monthly statement for all charges considered “patient responsibility.” Our policy is that all payments should be made in no more than 90 days. For your convenience, we accept most major credit cards. Please contact our billing department if you need special arrangements.
Princeton Radiation Oncology works with you and your insurance company to make sure you get the cancer care you need. Our job is to give you easy access to top-quality, comprehensive, leading edge cancer treatment. At PRO we focus on every patient, individually.