Billing and Insurance


  Billing | Insurance | Patient's Bill of Rights

Thank you for choosing our practice. As a patient of Advanced Cardiac Specialists you will be required to sign a financial responsibility and authorization for treatment form.

For personalized service on your account, please stop by or call our billing office.

We are located at 4838 E. Baseline Rd., Suite 122 in Mesa, AZ. (Directly across from the Gilbert/Mesa Clinic.)

Our phone number is 480-288-4089 or if you are calling from outside of Arizona call 1-800-73-PULSE (78573).

Hours of Business are Monday – Friday 8:00 A.M. – 4:30 P.M.



 

Billing

Insurance Billing

Advanced Cardiac Specialists billing department will submit bills to the patient’s insurance plan if the patient has supplied us with current and correct information. Our policy is to allow the insurance carrier 60 days to pay a claim. If a payment has not been received from an insurance carrier within 60 days, we may request the patient’s assistance in working with the insurance carrier for payment.

The insurance carrier is a contract between patient, patient’s employer and/or patient’s insurance company. It is patient’s responsibility to know and understand their plan benefits, as well as any deductible and co-payment amounts that they are responsible for paying.

Please note: not all services are covered in all insurance contracts. If patient’s insurance plan does not cover a service or procedure, the patient will be responsible for the charges.

Automobile insurance can be billed for any motor vehicle accident with no payment required at the time of service. It is the patient’s responsibility at the time the services are rendered to give the motor vehicle insurance information along with the insurance claim number. However, patients will be billed for any remaining balance after 60 days.

Co-Payments

It is the policy of Advanced Cardiac Specialists that patients are prepared to pay their required co-payment at the time service is rendered.

Self-Pay Patients

All patients that present without valid insurance information are considered Self-Pay patients. It is the policy of Advanced Cardiac Specialists to offer a 50% discount when full payment is received at the time of service. Please be prepared to make this payment with our front office personnel at the time of check out.

Should you have insurance but are unable to provide information at the time of your visit you may contact our billing office at 480-288-4089.

Referrals and Pre-Authorization

If the patient has an HMO or a Multi-Tiered HMO health insurance plan, it may be necessary for the patient to obtain a referral before making an appointment with an Advanced Cardiac Specialists specialist.

If the patient’s Primary Care Physician is not an Advanced Cardiac Specialists provider, patient must provide proof of referral upon scheduling their appointment.

Many insurance companies, including HMO (managed care) and PPO, require a primary care physician to initiate referral and authorization processes for services rendered inside and/or outside of our clinic.

Various specialty services may require additional review by the health insurance plans. Some examples of services that require review or pre-authorization are: diagnostic testing, sleep studies, physical therapy, procedures, surgeries, medical equipment, home health care and second opinions.

Our goal is to provide services in a timely manner. However, once the request is transferred to the insurance company and additional review is required, we must await their response.

Statements

Patient statements are sent out monthly. Payment is due upon receipt.

To inquire about a statement that you have received for physician services, please contact the Billing Office at 480-288-4089.

We accept Cash, Checks, Visa, Master Card and American Express. (Please do not send cash in the mail.)

 


 

Accepted Insurance Providers

We are a Ryan White (HRSA) Provider Part A. Service Location:

1690 W. Southern Ave.
Apache Junction, AZ 85120

Some affiliates may not be listed. We are continually adding new insurance providers.

If you have questions or you do not see your insurance provider listed, please contact our Billing Dept. 480-288-4089 or Ins. Contracting Dept. 480-288-4087.

For detailed information on Medicare Advantage Plans available:

Aetna
Ameriplan
Arizona Health Care Cost Containment System
(AHCCCS) Administration
Arizona Foundation for Medical Care (AFMC)
Arizona Medical Network (AMN/HMA)
Arizona Physicians IPA (APIPA)
APIPA Personal Care Plus
Arizona State Physicians Assn. (ASPA)
Assurant (affiliate Multiplan/PHCS)

Beech Street/Viant (PPO)
Benefit Options (State of Arizona)
Blue Cross Blue Shield of AZ & out-of-state
Bridgeway

CCN Managed Care, Inc. Dba CCN (See First Health)
Choice Care Network (AMN Ntwk)
CIGNA-PPO / HMO-commercial.
CIGNA HealthCare for Seniors Only Specialists
CorVel / CorCare (Fortis) PPO Only
Cofinity (Aetna affiliate)
Coventry/First Health

Evercare / Evercare Select

Fortified Provider Network (PPO)

Galaxy Health Network (PPO)
GEHA
Gila River Health Care Corporation
Great-West Healthcare (CIGNA affiliate)

Health Choice Arizona
Health Choice Generations
Health Management Association (HMA)
Humana Gold Choice® PFFS plans

Indian Health Services
Integrated Health Plan
Interplan Health Group

LifeWise Health Plan of AZ

Maricopa Health Plan
Maricopa Managed Care Systems (formerly MIHS)
Mailhandlers (CCN/First Health)
Medicare (We accept Medicare assignment.)
Medicare Advantage PFFS Plans
Medicare Supplements (most plans, i.e. AARP)
Mercy Care Plan
Mercy Care Medicare Advantage Special Needs Plan
MultiPlan (affiliate PHCS)

NALC (National Assoc. Letter Carriers)

PacifiCare-PPO only
Physician Health of AZ
Pinal / Gila Long Term Care
PHCS (Private Healthcare Systems, Inc.) See MultiPlan
Prime Health Services

Railroad Medicare
Rural Arizona Network (RAN)

SCAN Health Plan Arizona, Inc.
Sterling Medicare Advantage PFFS

Three Rivers Provider Network (TRPN)
TRICARE (Tri-West) CHAMPUS/CHAMPVA

United Healthcare
Universal Health Plan
University Family Care
University Physicians Care Advantage
University Physicians Healthcare Grp of AZ
USA Managed Care Organizations, Inc.

Viant

 


 

Patient's Bill of Rights & Responsibilities

Overview

Patients have both rights and responsibilities when it comes to their health and the health care services they receive. On March 26, 1997, President Bill Clinton appointed an Advisory Commission on Consumer Protection and Quality in the Health Care Industry. As part of its work, the Commission issued a Consumer Bill of Rights and Responsibilities. This document was intended to serve as a blueprint to how systems and procedures should be developed that aim to protect consumers and improve quality of care.

Patient's Bill of Rights

I. Information Disclosure

You have the right to receive accurate and easily understood information about your health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just do not understand something, assistance will be provided so you can make informed health care decisions.

II. Choice of Providers and Plans

You have the right to choose health care providers that are sufficient to provide you with access to appropriate quality health care.

III. Access to Emergency Services

If you have severe pain, an injury, or sudden illness that convinces you that your health is in serious jeopardy, you have the right to receive screening and stabilization emergency services whenever and wherever needed, without prior authorization or financial penalty.

IV. Participation in Treatment Decisions

You have the right to know all your treatment options and to participate in decisions about your care. Parents, guardians, family members, or other individuals that you designate can represent you if you cannot make your own decisions.

V. Respect and Nondiscrimination

You have a right to considerate, respectful and nondiscriminatory care from your doctors, health plan representatives, and other health care providers.

VI. Confidentiality of Health Information

You have the right to talk in confidence with health care providers and to have your health care information protected. You also have the right to review and receive copies of your medical records. You may also request that your health care provider amend your record if you believe it contains inaccurate, not relevant, or incomplete information.

VII. Complaints and Appeals

You have the right to a fair, timely, and objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel. Complaints concerning Advanced Cardiac Specialists should be sent to: Advanced Cardiac Specialists, Administration 4838 E Baseline Rd, Building 3, Suite # 122 Mesa, AZ 85206. Phone: 480-545-1808.

Patient Responsibilities

You are responsible for providing as much information as possible about your health, medical history, and insurance benefits.

You are responsible for asking the health care provider when you do not understand medical words or instructions about your plan of care.

You are responsible for following your plan of care. If you are unable/unwilling to follow the plan of care, you are responsible for telling your health care provider. Your health care provider will explain the medical consequences of not following the recommended treatment. You are responsible for the outcomes of not following your plan of care.

You are responsible for following the clinic’s rules and regulations.

You are responsible for acting in a manner that is respectful of other patients, staff and clinic property.

You are responsible for meeting your financial obligation to the clinic.