Insurance & Billing

The staff at your referring clinic will collect insurance information and discuss cash pay options with you prior to scheduling your surgery. This information will be passed along to Independent Surgery Center who will contact your insurer to verify benefits specific to your plan. You will then be contacted by our staff to resolve any issues or to inform you of any co-pays, co-insurance, or deductible which will be due on the day of surgery. In most cases, we should be able to estimate the cost of your surgery upfront, and our Business Office staff will help you finalize your financial arrangements before your surgery. Please arrive on the day of surgery prepared to meet any financial responsibility. Patients with a high-deductible insurance plan, or those without any coverage will be required to make a payment before the procedure is performed.

How Much are You Financially Responsible for Prior to Surgery?

If you have MEDICARE: Medicare has a set rate for every surgery. You are responsible for 20% of this rate, which can be covered by secondary insurance or with a payment to ISC prior to surgery.

If you have INSURANCE: Charges vary for surgery based on the contracts your insurance company has negotiated with ISC. These contracts provide a discount off of ISC’s normal published rates.

The insurance plan information you received from your insurance carrier describes, in detail, your responsibility for deductibles, co-insurance and co- pays for outpatient surgery.

If you are UNINSURED: ISC rates are used to determine your financial responsibility. ISC offers a discount for cash payments, and accepts credit card payments or Care Credit Financing as well.

How Much Will Surgery at ISC Cost?

The facility fee and the anesthetist’s fee are billed by ISC. The cost of surgery at ISC will depend on the type of surgery you are having. These charges cover the use of the surgery center, its equipment, staff, and the supplies needed to perform the surgery.

Each surgery (cataract, corneal transplants, SLT, YAG, etc.) has a specific charge/rate assigned for the facility portion of the surgery.

The fees charged by your surgeon to perform the surgery are separate and will be charged by the surgeon’s office/clinic.

Will You Receive Statements or Bills After Surgery?

After surgery, Medicare and/or your insurance company will be billed by the clinic/ surgeon’s office and ISC. You should receive an EXPLANATION OF BENEFITS (EOB) statement from your insurance company explaining the charges they received. This is NOT a bill.

Please wait for a statement/bill from ISC before submitting a payment after surgery. Please remember, you will receive 2 bills or statements pertaining to the day of your surgery:

• 1. A statement for the cost of using the facility, the cost of anesthetist’s services, and any premium lens fees will come from Independent Surgery Center, LLC.
• 2. A statement for the surgeon’s fees for performing the surgery will come from the surgeon’s office/clinic.
• 3. A statement for the surgeon's fees for pending the surgery will come from the surgeon's office/clinic.

What part of the surgery center fees are your responsibility?

Patients with MEDICARE ONLY (no supplemental/secondary insurance)

You will be responsible for 20% of the Medicare allowable charge for the facility and anesthetist’s fees at ISC. Your portion of the facility fee is due prior to surgery.

STEP 1

Determine the FACILITY FEE payment due prior to surgery.

• Contact your Medicare Provider using the number on the back of your Medicare Card.
• Describe the type of surgery you are having, and make sure to tell the provider your are having surgery at an OUTPATIENT AMBULATORY SURGERY CENTER, and that you are asking about the FACILITY FEES.

STEP 2

Contact ISC at 715-738-1800 to confirm the 20% payment you will need to pay prior to surgery.

• Inform ISC about the method of payment you will be using to pay for your co- insurance (Cash, Check, Credit Card or Care Credit Financing).
• Bring payment to ISC on the day of your surgery. Make checks out to: Independent Surgery Center, LLC.

STEP 3

Understand the ANESTHETIST’S FEE due.

• This charge is based on the services performed by the anesthetist in the operating room and cannot be determined prior to surgery.
• You will be billed for your anesthestist’s related fees after surgery (the financial responsibility of a Medicare-only patient for anesthetist’s services is usually under $50).

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Patients with Medicare AND Supplementary/Secondary Insurance

Your secondary insurance will likely cover the 20% co-insurance you are required to pay for Medicare. However, it is the patient’s responsibility to confirm this. If not covered, your portion of the facility fee is due prior to surgery.

STEP 1

Call your secondary insurance carrier using the number for Customer Service on the back of your insurance card.

• Give the Customer Service Representative details of your upcoming surgery to determine if they will cover the 20% co-insurance required by Medicare.
• Make sure you tell your insurance company that you are having surgery at an OUTPATIENT AMBULATORY SURGERY CENTER, and that you are asking about the FACILITY FEES.

STEP 2

If the secondary insurance company tells you they WILL cover the 20% Medicare co-insurance in full:

• Do nothing. No payment will be due to ISC out-of-pocket. All bills will be sent to Medicare and your secondary insurance company.

If the secondary insurance company tells you they will NOT cover the 20% Medicare co-insurance in full:

• Contact ISC at 715-738-1800 to confirm the 20% payment or co-pay/deductible amount you will need to pay prior to surgery.
• Inform ISC about the method of payment you will be using to pay for your co- insurance (Cash, Check, Credit Card or Care Credit Financing).
• Bring payment to ISC on the day of your surgery. Make checks out to: Independent Surgery Center, LLC.

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Patients with COMMERCIAL INSURANCE ONLY

In the United States, there are thousands of different insurance plans available to patients from hundreds of insurance companies. The patient’s financial responsibility comes in the form of deductibles, co-insurance and co-pays. All deductibles, co-insurance and co-pays are due prior to surgery.

In most cases, it is impossible to determine what you will owe (if anything) without contacting your insurance company.

STEP 1

Review the insurance plan information you receive from your insurance carrier. This information describes the items the insurance company has agreed to pay for and your financial responsibility, based on the contract you signed with the insurance company.

STEP 2

Call your primary insurance carrier using the number for Customer Service on the back of your insurance card.

• Give the Customer Service Representative details of your upcoming surgery to determine your deductibles, co-insurance and co-pays.
• Make sure you tell your insurance company that you are having surgery at an OUTPATIENT AMBULATORY SURGERY CENTER, and that you are asking about the FACILITY FEES.

STEP 3

If you have additional/secondary insurance, call the insurance carrier using the number for Customer Service on the back of your insurance card.

• Follow the directions listed in STEP 2 above.

STEP 4

Call Independent Surgery Center, LLC at (715) 738-1800 with the information you received from your insurance carrier(s).

• Confirm the amount you will need to pay to ISC prior to surgery.
• Inform ISC about the method of payment you will be using to pay for your deductible, co-insurance and co- pays (Cash, Check, Credit Card or Care Credit Financing).
• Bring payment to ISC on the day of your surgery. Make checks out to: Independent Surgery Center, LLC.
• If you are not able to pay for the deductible, co-insurance or co-pays prior to surgery, your elective surgery will have to be delayed until you are in a better financial position.

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UNINSURED Patients and Out-of-Network Patients

Call Independent Surgery Center, LLC at (715) 738-1800 to request a quote for the facility fee portion of your upcoming surgery at ISC. All fees are due prior to surgery.

• Discuss the method of payment you will be using to pay for your surgery (Cash, Check, Credit Card or Care Credit Financing) with ISC’s billing personnel.
• Bring payment to ISC on the day of your surgery. Make checks out to: Independent Surgery Center, LLC.
• If you are not able to pay for the deductible, co-insurance or co-pays prior to surgery, your elective surgery will have to be delayed until you are in a better financial position.