Outpatient Surgery Financial Information

You have been scheduled for an upcoming surgery at River Hills Surgery Center with your Iowa Ortho surgeon. We know that billing and finances for surgery can sometimes be difficult to understand. We want you to be informed and prepared for what may come.

Billing Expectations

Outpatient surgery at an Ambulatory Surgery Center, such as River Hills Surgery Center, is usually more cost effective and convenient than having surgery at a big hospital. Your insurance will get bills from all the different providers and facilities for their portion of the surgery – such as a physician bill, a surgery center bill, an anesthesia bill, lab bill, etc. If you have a deductible or co-Insurance that apply to surgery, you could get several different bills for the same date of service.

Familiarize yourself with your insurance plan as soon as possible.
Call the number on the back of your card and ask what your benefits are for outpatient surgery and how much you may be responsible for. Your surgery will most likely get applied to your deductible and co-insurance cost which YOU will be responsible for paying.

We will collect a portion of what you owe before your surgery.
As most surgery centers do, we will look up your benefits around a week prior to your surgery to verify your deductible and/or out of pocket remaining for the year, and if that will apply to this visit. We will call and inform you of the portion we will pre-collect. Any remaining balance, after insurance processes, will be due according to our financial policy and the timelines defined there. You may also have to pre-pay a portion to your physician’s office as well. Failure to pay may result in your surgery having to be rescheduled or even cancelled.

We have contracts with your insurance that we have to follow.
We send charges to your insurance and they are the ones that determine what is covered, what they will pay, and what we must bill you, in most cases. The monthly premium you pay each month doesn’t mean that you won’t have to pay anything more for medical care.

Insurance Terms

Allowable
All insurance plans have different allowables for procedures depending on their contract with the provider and sometimes their geographical area. This means someone that has Insurance A may owe more for a surgery than someone with Insurance B if Insurance A allows more for that service. Again, that is something we have to abide by in our contract with insurance companies. It is not the provider making this decision based on patient.

Deductible
This is the annual amount YOU may have to pay BEFORE the insurance will begin issuing payment toward the balance of the claim submitted. Some things do not apply to the deductible and you may only have to pay a co-pay for those (i.e. Office visits) but surgery most often does apply to deducible plans.

Co-Insurance
(Usually after the deductible is met) This is the portion of the remaining allowable you will pay and the insurance will pay the other portion. (i.e.: if your coi is 20% and the remaining bill is $100.00 – you will pay $20.00 the insurance will pay $80.00)

Out Of Pocket
This is usually the maximum amount you will pay for services within your insurance term (usually calendar year). Deductibles and Co-Insurance most commonly all go toward this OOP amount so once you have accumulated a TOTAL between Deductible and Coi payments that equal your OOP, the insurance will pay the remaining balances for the remainder of the year

Individual vs. Family Plans
If you are on an individual or family plan, different stipulations may apply depending on your type of insurance. At River Hills Surgery Center, we look up all benefits for your individual benefits first and calculate our estimate.

Financial Arrangements

River Hills Surgery Center will charge for the use of the facility, which includes the costs of the operating room, recovery room and supplies for your surgery.  Your surgeon, anesthesiologist and if applicable, your physician assistant, radiologist and pathologist will bill you separately for their services. 

As a courtesy to you, we will file most insurance claims for you.  However, if your insurance company denies payments, you may be responsible to pay for all services related to your surgery. For questions regarding your coverage and/or possible remaining patient financial responsibility, please contact your insurance company directly.

To pay your River Hill Surgery Center bill online, click the “Pay Bill Online” button in the navigation.

Pre-Estimates
In some cases we are able to pre-estimate the cost of your facility charges and determine what balance you may have after insurance processes your claim.  This information will be reviewed with you prior to surgery. A portion of your pre-estimated costs will be collected on the day of your surgery and applied to your account.

Any remaining balance due after your insurance company processes the claim will be billed to you and is subject to our financial policy.   

Financial Policy
Patient balances are requested to be paid in full upon receiving the first statement.  If you are unable to pay in full please contact us and our staff will be happy to go over payment options with you.  A copy of our full financial policy is available upon request.

We also accept CareCredit. With CareCredit you can extend payment plans for 6, 12, 18, or 24 months with deferred interest. Longer time frames are also available with an interest rate applied. Call CareCredit to apply at 1-800-365-8295 or click here to visit their website for more information.

River Hills’ financial department can be reached at 515-323-6454.

To pay your Iowa Ortho bill online for the services of your orthopedic surgeon/physician assistant, please click here. If you have questions about your Iowa Ortho bill, please contact the billing department at 515-247-9511.