Insurance Information
Insurance Issues
When searching for the best treatment option, cost may be one of your considerations. Although Scott D. Miller, MD does not participate in discounted contracts with insurance carriers, his professional services are often partially covered by insurance companies’ out-of-network benefits. The hospital-based services (operating room, hospital stay, anesthesia, and pathology) that go into the bulk of the total cost are usually covered as expected.
The result: your out-of-pocket payment may be slightly higher, but the quality of care and level of outcome you receive are given the utmost attention.
Knowing that most people are not very experienced with health insurance issues, our office works with our patients to make the reimbursement process as easy as possible. We start with fair pricing based on the work required to provide laparoscopic and robotic services. By no means do we charge what the market will bear, nor do we unfairly vary our charges based on an individual patient’s circumstances.
Prior to surgery, each patient will have a close estimate of what portion of our charge will be their responsibility.
Our knowledgeable billing staff will also submit all appropriate claims for Dr. Scott Miller’s services to the insurance carriers on behalf of our patients. Furthermore, we provide any additional supporting documents such as operative reports, pathology results, prior authorizations, and appeal letters.
Some patients wonder why Dr. Scott Miller is not a participating provider in their insurance plan. A contract between an insurance company and a physician usually involves the physician agreeing to provide services at a discounted rate in return for access to treat the covered patient population. Typically, laparoscopic and robotic procedures tend to be reimbursed at much lower rates than other services provided by a general urologist, especially when considering the necessary time and level of expertise required. Although a general urologist can make up for this imbalance by providing more highly compensated services, Dr. Scott Miller specializes exclusively in laparoscopic and robotic urology so that his patients get the best possible care. In addition, the patients brought to a urologist under this type of contract encompass general urology issues outside the scope of Dr. Scott Miller’s practice. Fortunately, he has 30 other wonderful urologists in his group to provide those services.
Insurance FAQs
Q: Will my surgery be covered by my insurance?
A: Insurance coverage varies by company and by your individual coverage plan. Your insurance company will often pay a portion of the fees and you will be responsible for the balance. When you provide us your insurance information, our staff will explain what portion of your charges will be covered by insurance and what portion will be paid by you.
Q: Will I get separate bills from the hospital and Dr. Scott Miller?
A: Yes. Hospital charges and surgical fees are separate. Typically, the hospital fees include charges for operating room, hospital stay, anesthesia, and pathology services. Dr. Scott Miller is not an employee of the hospital and his fees for performing surgery are a separate charge.
Q: If Dr. Scott Miller is out of my “network”, will my insurance company pay his fees?
A: Most insurance companies provide partial coverage for out-of-network physicians. You will be billed for the remaining balance.
Q: Why doesn’t Dr. Scott Miller participate in my insurance plan?
A: A contract between an insurance company and a physician usually involves the physician agreeing to provide services at discounted rates for members of the insurance plan. Some insurance carriers have been slow to respond to the costs associated with the training and expertise required to achieve excellence in laparoscopic and robotic surgery. Dr. Scott Miller’s fees are fairly priced based on the highly-skilled work and sophisticated technology required to perform advanced laparoscopic and robotic surgery.
Q: Will your office help me deal with my insurance company?
A: Yes. Our knowledgeable billing staff will check your coverage and submit all appropriate claims (including appeals) for Dr. Scott Miller’s services to the insurance carrier on your behalf.
Q: What insurance forms or information do I need to bring to Dr. Scott Miller’s staff?
A: Please bring your insurance card(s), a form of personal identification (such as a driver’s license) and any information related to cancer care insurance policies (if you have them).
Q: Does Dr. Scott Miller accept Medicaid or Medicare?
A: Dr. Scott Miller is not a Medicaid or Medicare provider. However, all hospital-associated charges (the majority of total charges) are covered as expected.
You may have other questions about your insurance, and we’re happy to help you. Simply contact our office during normal business hours and a member of the staff will speak with you.
