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OB Sonogram Billing and Insurance Information

Billing and insurance questions always seem to cause confusion and anxiety. Hopefully we can relieve that.

All of our OB sonograms, except for multiple pregnancies, are billed at $ 160.00 each. We do however offer a substantial cash discount for those that pay at the time of service. This is true for exams we do at our office in Bedford, or at a mobile site such as a physician office or birthing center.  Follow up examinations, if deemed necessary by our office, will also be discounted. Please understand that follow up exams are limited to a very specific area.

Payment or payment arrangements are expected at the time of service. We accept cash, money orders, checks, and all major credit cards.

If you are planning on using your insurance benefits, it is important for you to know what they will and will not pay for. Prior to your appointment, please review the following information:

How To Check Your Insurance Benefits

Most insurance companies have certain facilities and physician offices that are considered IN-NETWORK providers. This means they have made an agreement on how much they will pay for services.Professional Ultrasound Imaging, Inc. is notconsidered an IN-NETWORK provider by most personal insurance companies such as, Aetna, BCBS, and United Healthcare. They consider us be an OUT-OF-NETWORK provider which means your insurance may not cover the cost of your sonogram like it would if we were considered an IN-NETWORK provider. It is in your best interest to know your benefits and get insurance informationprior to your appointment.  Here are a few tips that will help you determine, prior to your appointment, whether or not you would like Professional Ultrasound Imaging, Inc. to file a claim on your behalf or if you would like to take advantage of the discounted cash rate.

How do I find out what my insurance company will pay?

Most insurance cards have a Customer Service phone number or website, either on the front or back of your insurance card. Please visit the website or call the number on your card and follow the prompts to speak to a customer service representative.

What information will I need to give the insurance representative?

You will need to keep your insurance card handy. You may be asked what your ID or Subscriber ID number is. You may need to provide your social security number or the social security number of the person who is policy holder. This is sometimes needed to locate your specific insurance plan.

What information should I ask the insurance representative to give me?

Let the insurance representative known that you are planning on having an obstetrical ultrasound with an OUT-OF-NETWORK provider. Inform them that you need basic benefits such as, your yearly deductible, if any of your deductible has been paid and at what percentage will the insurance company pay after your deductible has been paid in full. If your deductible has not been paid, you are to pay the entire $160, if claim is filed and denied.

How will I know what my financial responsibility will be?

Professional Ultrasound Imaging, Inc. bills all insurance companies $160 for each sonogram performed. If your deductible has been paid, and depending on your specific insurance percentage benefits, will determine what amount you will be responsible for at time of service. As an example, some plans will pay 60% of the charges for an out of network provider, meaning you will be responsible for the remaining 40%

Won’t my co-pay take care of my visit?

No. As an OUT-OF-NETWORK provider co-pay’s can not be applied

What if I don’t want to file with my insurance?

Professional Ultrasound Imaging, Inc. offers a cash discount to those that do not file a claim with their insurance company.  You will be required to pay $100 on the date of your visit. All major credit cards, cash, money orders and checks are accepted.

Can I pay the $100 and still file a claim with my insurance company?

No. This is considered insurance fraud. It is illegal for Professional Ultrasound Imaging, Inc. or yourself to file a claim with your insurance company and not charge the full amount.

If you have any questions, please do not hesitate to contact our office. Also, please remember that a signed referral by your Physician or Midwife is required to do the study. Please visit our forms page to print and fill out the necessary patient information prior to your visit, which will make your visit all the more enjoyable.

 

 

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