6161 Clairton Rd
Please be aware that any balance is your responsibility.
Following our verification of insurance benefits with your carrier, you will be notified of any deductible, co-insurance or facility co-pay obligations. You are expected to pay your deductible, co-insurance and/or co-pay on the date of your surgery.
SHSC recognizes its obligation to maintain flexibility with financial matters. In the event you're unable to meet your financial obligations on your date of service, you must call the facility and speak with the business office to make payment arrangements.
Please understand that you will receive a separate bill from your surgeon, anesthesia provider and/or pathologist.
We accept cash, checks, Visa, Mastercard, Discover and American Express.
It's important that each individual understands the uniqueness of their insurance benefits and coverage including, but not limited to, outpatient procedures and/or outpatient facilities. Remember, all insurance carriers provide contact information for patient care representatives to assist you in understanding your benefit plan.
If you have questions regarding your bill and wish to speak with someone directly from our billing office, please contact AT&C Revenue Services at 1-855-371-6020.
Explanation of Benefits
Most of us have seen an Explanation of Benefits or EOB but, what does it mean?
After you've visited a doctor, clinic, hospital and/or ambulatory surgical facility, you will receive an EOB from your insurer. Most people don't understand this form, and because it includes a notice that it is "NOT A BILL", they discard it. However, the EOB is the result of the claims process.
If your provider is a part of the provider network, and you have an insurance plan using this network, the provider usually sends your bill to the network to the network discount calculated. The network sends the claim to your insurance administrator. If your provider is NOT in the network, the provider may send the bill to your or your insurance company. If the bill is sent to you, you'll submit the claim to your insurance administrator.
The insurance administrator reviews the claim to determine your benefits. If and when another insurance company is involved, the insurance companies coordinate benefits to determine which plan is responsible for the charges. The EOB is often generated and sent to you once your provider receives a check.
Tips to Help You Understand your EOB:
The most important information on your EOB is a table that includes specifics of the services or procedures received. For each service for which your provider is seeking reimbursement, there is a description of the services along with a corresponding code and the date the service was provided. If you have questions or require additional information, you should call the number or visit the website provided on the EOB.
Charges Covered by Your Insurance:
Following the service description is a column called "billed" or "submitted" charges. This is the amount that your provider billed you or your insurer for the service. The next column may be called "allowed charges", "negotiated amount" or "allowed amount" (terminology varies amongst insurance carriers) â€“ this is the amount your plan agreed to pay network providers for the service. However, if you provider is not in your health plan's network, this amount generally reflects the price upon which your insurer will base reimbursement.
You will also see a column labeled "not covered," "not payable," or "pending" â€“ these are charges your plan does NOT cover. Typically this is the difference between what your provider billed and the allowed charge covered by your plan.
The next columns correspond to details of your health plan. "Co-pay" amount is what you are required to pay a provider for most visits. Generally, this is paid on your date of service. Under "deductible" amount, usually expressed as an annual total, you see the amount you are required to pay for covered healthcare services before your health plan will pay any benefits to you.
The next columns add and subtract charges and deductions that appear previously on the EOB. Under "payable amount," or "plan pays," you will see the total amount your plan will cover. This is equal to the allowed charges minus your deductible, co-insurance (the percentage of covered charges that you are responsible for), and co-pay amounts. The final column may be labeled "patient responsibility" or "member pays." This is the amount you are responsible for paying your provider directly.
NEVER Make Payments Based on Your EOB!!!
Remember, don't make any payment based on an EOB â€“ IT IS NOT A BILL!!! If you haven't already, you will receive a bill from your provider or healthcare facility for the amount you owe.
If you have questions about your EOB, or believe that your claim was not resolved properly, contact your insurance plan. Often times, the phone number for your plan is located right there on the EOB.
And, remember, you can always contact your insurance plan by calling the phone number on the back of your insurance card(s).
Open 5 Days per week.