Affiliated Surgeons of Rockford (ASR) has a team of medical billing staff to properly bill all insurance claims, given the correct information at the time of service. It is your responsibility to ensure that we have the proper insurance at time of registration. ASR requires a copy of a photo ID along with copies of your health insurance card(s).
ASR will bill all insurance claims at primary, secondary, and tertiary levels. Once payment is received from your insurance carrier(s), any remaining balance will then become patient responsibility, and a statement will be mailed. Payment is due upon receipt.
With healthcare changes happening more often than ever, it is your responsibility to determine whether our physicians are in or out of network for your specific insurance plan. Additionally, your patient demographics are updated at each visit and re-verified through your signature on an annual basis.
Surgical/Procedural Prepayments
Medicare Supplemental Insurance
Workman'sCompensation/Liability/Vehicle Insurance Claims
Surgical/Procedural Prepayments
As part of the process of scheduling your surgery, our billing department will be contacting your insurance company in order to determine your insurance benefits. After we verify your insurance benefits, we will inform you of your financial obligations. These may or may not include co-insurances, deductibles, and/or out-of-pocket expenses which we will collect prior to your surgery. ***Note: These amounts are estimates; the final amounts will be determined after the claim is submitted to your insurance carrier(s).***
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Payment Types
ASR accepts all major credit cards: Visa, MasterCard, Discover, and American Express. Additionally, some financing through outside companies may be available.
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Medicare
Medicare assignment is accepted. Your ASR physician has agreed to accept as payment the amount which Medicare determines to be allowable. Your co-insurance (20% of the Medicare allowable), any remaining portion of your annual deductible, and all non-covered charges then become the patient's responsibility. A statement will be mailed and payment is due upon receipt.
If you have a Medicare Replacement or Medicare HMO product as your primary insurance, your Medicaid/IDPA card will not be accepted as payment for tertiary or alternate insurance payment.
Medicare requires Advanced Beneficiary Notices (ABN) for some testing done at the office for non-covered services and items deemed not medically necessary. In such events, if Medicare does not allow the charges, the amount will then become patient responsibility. A statement will be mailed and payment is due upon receipt.
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Medicare Supplemental Insurance
ASR will automatically submit your claims to any supplemental insurance provided to our office. Once payment is received from your supplemental insurance carrier(s), any remaining balance will then become patient responsibility. A statement will be mailed and payment is due upon receipt.
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Self Pay/Uninsured
If you are not currently covered under any type of insurance, you are responsible for paying your account at time of service. A consult fee will be collected upfront at registration. Additional charges may be assessed at the end of your visit.
In the event that you do not have your insurance cards at time of service, your account will be set up as a self-pay account, and you will become responsible for all charges incurred. Additionally, you will be responsible for submitting your claims to your insurance company.
Self-pay accounts may be eligible for financial hardship assistance, and other options may be available to you. Please ask for more information.
Quotes are available for surgical needs and are valid for (6) months.
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Commercial Insurance/PPO's
New insurance cards are required at each change in your policy, and/or minimally on an annual basis.
Co-pays are due at time of service. Your appointment may be canceled for lack of co-payment. In the event the office co-pay is not paid at the time of visit and we are required to send a statement to your home to collect, a $20.00 service charge will be added to your account. This amount is your responsibility.
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HMO's
New insurance cards are required at each change in your policy, and/or minimally on an annual basis.
Co-pays are due at time of service. Your appointment may be canceled for lack of co-payment. In the event the office co-pay is not paid at the time of visit and we are required to send a statement to your home to collect, a $20.00 service charge will be added to your account. This amount is your responsibility.
If your insurance company requires a written referral to visit our physicians, it is your responsibility to obtain a valid referral through your insurance company. (i.e. BCBS HMO (PCN)). If you do not have a valid referral for today's visit you must sign a waiver and we will not bill your insurance for the visit, or you may reschedule until you obtain a valid referral.
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Workers' Compensation/Liability/Vehicle Insurance Claims
It is your responsibility to provide ASR with all insurance carrier information along with a contact person's name and number, the date of injury, the claim number and type of injury. If all information is not provided, this account becomes self-pay and is then your responsibility to file with your employer.
Your medical/health insurance information must be received at time of service as well. In cases where your policy limits have been met, ASR will bill your health insurance if the information is provided; otherwise, payment will become patient responsibility and a statement will be mailed. Payment is due upon receipt.
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Collections
Balances appearing on the "Patient Balance" column of your statement are due upon receipt. Patients will be responsible for any additional charges related to the cost of the collection of their account, including, but not limited to, collection agency commission, reasonable attorney fees, and costs of suit which are incurred by the clinic in enforcing these policies. Charges will not exceed 50% of the original balance due to ASR.
For any disputes regarding your account, you may contact the ASR billing department at (888) 786-0607, Monday through Friday, 7:30 p.m. to 5:00 p.m..
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