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Credit & Payment Policy

There are a number of separate charges associated with your surgical procedure.  You MAY receive charges from several companies.

  1. Charlotte Surgery Center, facility services.
  2. Pain Management & Anesthesiology Associates, anesthesia.
  3. Your surgeon's office: his/her fee for performing your surgery.
  4. Your pathologist: services for tissue specimens removed during surgery requiring further examination.
  5. An extended home health care service.
  6. Durable Medical Equipment vendors.

Full payment is due within 60 days from your date of service.  Please contact your insurance company directly if you experience any delays.  YOU are responsible for guaranteeing payment on your account and being aware of your individual policy restrictions and benefits.

Your insurance company, including Worker's Compensation, auto (no fault) and personal injury, is legally responsible to you.  Our relationship is with you, our patient, not your insurance company.  Consequently, all charges incurred are your responsibility.  The obligation to assure payment in a timely manner lies with you regardless of what your insurance company chooses to do.  You should normally receive a response from your insurance company within 30 days of your date of service.  If you experience a delay, it is expected that you contact your insurance company to check the status of your claim and to expedite payment.  Please call our Regional Business Office at (844) 252-3618 if you encounter a problem with your insurance company and need our assistance.

Charlotte Surgery Center's policy is to turn over to an attorney or collection agency all accounts which are delinquent.  You will be responsible for any collection fees that are incurred. We utilize Transworld Systems and Credit Management Services as our collection agencies.                 

MEDICARE
We accept assignment of benefits.

PRIVATE INSURANCE  
As a courtesy to you, we will verify your benefits to determine eligibility and your patient responsibility. Your co-pay, any co-insurance and any unmet deductible responsibilities is due on or before your date of service.  We will submit your bill directly to your private insurance company for the remainder balance due after patient responsibility.  If you have a secondary insurance provider, and if you provide us with your subscriber information we will submit a bill to the secondary insurance upon receipt of payment or denial from your primary insurance.  If you have no secondary insurance, a bill will be sent directly to you for any balance after receipt of payment or denial from your insurance company.   Please provide us with your insurance card(s) at the time of registration.

SELF PAY
A Financial Advocate will contact you, as soon as practical and prior to your surgery, to discuss the procedure cost and any other benefits that may be available to you as a self-pay patient. All self-pay patients must make arrangements to provide payment in the amount of 100% of the procedure cost. We appreciate receiving your payment prior to the date of surgery.

SELF PAY - COSMETIC SURGERY - ELECTIVE SURGERY  
Payment in full must be received on or before date of service


NOTICE TO PATIENTS

A copy of our patient’s rights and responsibilities are posted in our patient lobby and if you have any complaints which arise out of these rights, Charlotte Surgery Center maintains a grievance mechanism to resolve them.  If you have a complaint, you may request a written response.  The person to whom you should address a grievance is:

 

Thomas Lally, CEO
Administrator
704-377-1647

If you wish to direct a complaint to the North Carolina Department of Health, the address is:

Complaint Intake Unit
2711 Mail Service Center
Raleigh, NC 27699-2711

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