It’s not easy to make sense of medical bills. Our financial counselors are here to help. They can provide the assistance and support you need every step of the way, whether by clarifying what is covered by your health insurance (please see our Insurance FAQ for commonly asked questions) or helping prepare you for what to expect for out-of-pocket expenses.
Insurance Authorization and Pre-Certifications
When your health insurance company requires authorizations and pre-certifications, it is up to you to ensure the referrals have been obtained. Failure to comply with your insurance company’s policies and guidelines could result in a denial of claims. UNC Fertility financial counselors can assist you in determining which referrals are required and can answer any questions you may have.
We contract with most major medical plans. See below for a step-by-step explanation of how the billing process works for our covered patients.
- After your first appointment we create a claim, based on specific requirements, in our patient account system.
- Next we send this claim to your health insurance company (if applicable). If there is no insurance or the services are not covered under your benefits we will send the claim directly to you. Your health insurance company will process the claims according to your benefit plan. Coinsurance or deductible amounts will be submitted to you for payment to our office in statement form, if not collected at time of service.
- Your bill will include an itemized list of charges as well as any payments received from your health insurance plan. These payment and charges should correspond to the Explanation of Benefits (EOB) you will receive from your health insurance company.
If you have coverage with a non-contracted insurance company, payment is expected at the time of service. UNC Fertility can submit a courtesy claim for you; this is a one-time claims submission, it is the patient’s responsibility to follow through on any requests from the insurance company. Usually, payment is made to the subscriber. If payment is made to UNC Fertility we will refund this money through our standard refund policy.
We only bill for the services we perform. You will be billed separately for services performed outside UNC Fertility directly from the outside provider.