Office and Financial Policies

Thank you for choosing to receive your care at Colorectal Care of New Jersey LLC (“our Practice”). We are committed to providing you with the best possible care. We also believe that no one should be surprised by their medical bill, which is often very confusing. We would like you to take a few moments to review our office and financial policies detailed below, so you can have full understanding of our fees and charges and your financial responsibility. If you have any questions or concerns, please do not hesitate to speak with Dr. Choi or one of our staff.

Patient Registration

All new patients are required to complete the online Pre-registration or fill out the paper Patient Registration form prior to or upon arrival for your first office visit with us. You will also need to show us your insurance card and a valid ID. The demographic information requested on the form and your IDs are needed for insurance verification purposes. Our office routinely verifies insurance eligibility status prior to office visits. If we are unable to verify your insurance status, your appointment may be delayed or canceled, unless you have alternative financial arrangements. Existing patients should inform our office of any change of insurance coverage and contact information. Your up-to-date insurance and other information will help us provide you with more accurate cost share estimate (co-pay, deductible, co-insurance, etc.) during the time of your visit.

Use of Patient Portal

Registration and use of the online patient portal is strongly encouraged. Through the patient portal, you can easily view your visit summary and other clinical information, request medication refill, communicate with us through secure messaging at a time convenient to you, and review bills and charges posted and pay your bills online. If you prefer, you may grant a family member or someone you trust full or partial access to your portal information to help you manage your health.

Insurance with in-network coverage

We will submit claims to your insurance company, who will then determine the final payment at the in-network/contracted rate. Your insurance company will pay our Practice the amount that is covered based on your specific plan and the insurance company’s policies. You are responsible for all charges not covered by your medical insurance plan, including but not limited to co-payments, deductibles, co-insurances, and non-covered services. See below for more explanations regarding these charges. Contact your insurance company if you have questions regarding your cost estimates and cost share.

Payment expected during your office visit

Depending on your insurance coverage, the following payments are expected at the time of service or upon receipt of Explanation of Benefit (EOB) from your insurance company. You may pay via credit or debit card, cash or check in our office, or via online bill payment through our patient portal.

• Co-payment: Co-pay of the amount specified by your insurance plan. You can usually find this information printed on your insurance card. Co-payment is expected at the time of service.

• Deductible: Your deductible is the amount you have to pay out-of-pocket for services before your insurance will start to cover any costs. Check with your insurance company if you are unsure of your deductible limit, and whether the office consultation and procedure will count toward the deductible. You may not need to use your deductible to pay for preventive care such as a screening colonoscopy.

• Co-insurance: After your deductible limit is reached, your insurance will start to pay for all or a part of the service. The co-insurance is the percentage you have to pay for the cost of a covered service.

Referrals

If your insurance plan requires you to have a referral from your primary care physician (PCP) to see a specialist, it is your responsibility to obtain the referral prior to your appointment. If you do not have the necessary referral, your appointment may be delayed or canceled, or you will be personally responsible for the cost of the office visit.

Non-covered services

Certain medical tests or treatments require prior authorization by insurance plan. Even though a service is considered medically necessary by Dr. Choi, your insurance company may ultimately determine that the service is not covered, i.e., they will not pay for it, because the service is not indicated or there is a less costly alternative. If the service was rendered prior to insurance denial, or if you elect to receive the service despite knowing that it may not be covered by insurance, you are responsible for the full payment of such non-covered service.

Medicare Part B

You are responsible for the deductible and the 20% co-insurance, which can be billed to a secondary or supplemental insurance if you have one. If the service is deemed non-covered by Medicare, we will provide you with an Advance Beneficiary Notice of Noncoverage (ABN), with which you will have the opportunity to accept or refuse the service.

Out-of-network care

If our Practice does not have a contract with your insurance plan (meaning we are out-of-network), but you have out-of-network benefit and elect to receive care at our Practice, you are expected to pay for any co-pay, co-insurance, deductible and non-covered amount at the out-of-network rate determined by your insurance plan. We will submit a claim to your insurance company on your behalf. Your insurance company may send payments to you and expect you to pay our Practice (instead of sending the payment to us directly). If you receive any monies that is intended to be the physician fee for our Practice from your insurance company, you are expected to send the payment to our office, or you can submit the payment through our Practice's patient portal online bill payment so we can get reimbursed. If you do not have out-of-network benefit through your insurance plan and elect to receive care at our Practice, you will be charged as a self-pay patient.

Charges for surgery and procedure

Dr. Choi may perform your surgery or endoscopy in a hospital or an ambulatory surgery center. A facility that is in-network with your insurance plan will typically be chosen, and you will be notified ahead of time if there is any insurance issue with regard to the chosen facility. You should expect to receive at least 3 separate bills – one from Dr. Choi for the surgical fee, one from the facility where the procedure will be performed, and one from the anesthesiologist. If a biopsy was taken during the procedure, you may get a bill from the lab/pathologist who performs a microscopic exam of the tissue for diagnosis. If you have a planned inpatient hospital stay after your surgery, the cost of the hospital stay is included as part of the facility fee. However, if your inpatient stay is longer or more complicated than expected (as determined by your insurance company), you may receive additional bills from the hospital. Also, if you receive care from another physician or advanced practitioner during the hospital stay (e.g. you develop irregular heart rate and were seen by a cardiologist), you may receive a separate bill from these other professionals. If you have any issues with the bills from these other parties, please contact them directly as our Practice has no control over their billing.

Fee schedule

If you have medical insurance coverage (whether in- or out-of-network), the fee schedule is determined by your insurance company. As such, you should contact your insurance company if you would like the most accurate estimate of your cost share or expected out-of-pocket expense of an office visit or a particular procedure. If you are self-pay, please call our office directly to inquire.

Self-pay patients

Full payment at time of service is expected unless other financial arrangements have been made prior to your visit. Please inform our office when you make your appointment. You may call our office directly to inquire about our fee schedule.

Payment options

We accept credit cards (VISA, MasterCard, Discover, American Express), debit card, cash or check in our office. You also have the option of online bill payment through our patient portal.

Credit card on file

When you use your credit card for payment, your card information will be store on file within our electronic medical record system, unless you specifically request us not to. The rationale for this policy is that insurance companies are increasingly transferring costs of care to patients, meaning you as an insured patient may have out-of-pocket expenses you may not expect or have planned for. We may charge your credit card for:

• Co-payment expected on the day of service, and the remaining patient responsibility not paid by your insurance, such as deductibles and co-insurances, after applicable insurance has been applied;

• Charges for non-covered services;

• Insurance discrepancies that are not resolved within 90 days of the date of service, such as when your insurance denies the claim or only pays part of the claim.

Your credit card information will be held securely and you will be notified before we charge your card. You will receive a detailed bill of the charges, and a receipt of any charges made to your card on file. You will have the option to change or cancel the credit card on file authorization at any time.

Timely payment

You are responsible for the timely payment of your account. We appreciate if you can respect and adhere to our policies. We are happy to answer any questions you have and work with you and your insurance company to avoid sending your account to an outside agency for payment collection. Some patients may qualify for a payment plan. We reserve the right to send delinquent accounts to an outside collection agency.

This document was last updated on April 30, 2024