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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. Any Pre-Op testing required would be billed in addition by the company performing the test
  2. Anesthesia services billed separately
  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

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 Business Office at 951-698-4670 if you encounter a problem with your insurance company and need our assistance.

Golden Triangle SurgiCenter'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.

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BILLING/COLLECTIONS

THE GOLDEN TRIANGLE SURGICENTER WILL BILL AS FOLLOWS:

MEDICARE
We accept assignment of benefits.

PRIVATE INSURANCE   
Your copay amount is due on or before your date of service.  We will submit your bill directly to your private insurance company.  A bill will be sent to your secondary insurance upon receipt of payment or denial from your primary insurance.  If you have no secondary insurance, a bill will be sent to you for any balance after receipt of payment or denial from your insurance company.  We must make a copy of each insurance card at the time of registration.

SELECT CARE   
Your Select Care copay amount is due on or before your date of service.  We will submit your bill directly to Select Care.  A bill will be sent to your secondary insurance upon receipt of payment or denial from Select Care.  If you have no secondary insurance, a bill will be sent to you for any balance after receipt of payment or denial from Select Care.  We must make a copy of each insurance card at the time of registration.

SELF PAY
You will be contacted prior to your surgery with an estimated procedure cost for your surgery.  A down payment equal to 1/3 of the total estimated amount due is expected.  You will be asked to complete a financial agreement.  The remaining balance will be due within 90 days from your date of service.

SELF PAY - COSMETIC SURGERY - ELECTIVE SURGERY  
Payment in full must be received 10 days prior to surgery. 

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NOTICE TO PATIENTS

Golden Triangle SurgiCenter: Kelly Etheridge, Administrator
State Agency, Attn: 

DEPUTY DIRECTOR CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CENTER FOR HEALTH CARE QUALITY (CHCQ)
LICENSING AND CERTIFICATION DIVISION
P.O. BOX 997377 MS 3000
SACRAMENTO, CA 95899

COMPLAINTS (800) 236-9747

GENERAL INFORMATION (916) 558-1784

MEDICARE OFFICE OF THE MEDICARE BENEFICIARY OMBUDSMAN
www.cms.hhs.gov/center/ombudsman.asp


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