At Eye Surgery Center of San Francisco we recognize that financial considerations are very important to our patients. In an effort to provide the highest level of comprehensive care and service for our patients, ESCSF’s financial and insurance coordinators are available to explain the costs of treatment; however, we cannot tell you what your policy will cover. Since your insurance policy and coverage is between you and your carrier, we urge you to contact your insurance carrier prior to your procedure.
Your Eligibilities and Benefits
We know that understanding insurance benefits or obtaining necessary authorizations to begin treatment can be very confusing. To minimize financial anxiety, it is important to understand the processes that are required by your insurance plan. We recommend you to discuss your eligibilities and benefits options with your physician prior to your procedure.
If you are an HMO medical group patient, you must have an authorization from your ophthalmologist before your insurance carrier will approve your procedure to be performed at our facility.
Get to Know Your Insurance Plan
Be your own insurance advocate. Obtain a copy of your evidence of coverage booklet that has a detailed listing of included/excluded benefits. Take the time to read your insurance policy. It is better to know what your insurance company will pay before you receive a service, have testing, or fill a prescription. Determine your exclusions for coverage. If you still have questions about your coverage, call your insurance company and ask a representative to explain it.
Frequently Asked Questions
How do I know if my health insurance applies to Eye Surgery Center of San Francisco doctors and services?
Please call your health insurance company to ask about coverage. Your insurance company will have the most up-to-date information on its contracts with Sutter Health network facilities and doctors. Use the phone number or website on the back of your insurance card.
What do deductible, allowable amount, copayment and coinsurance mean?
When you have health insurance, your deductible, allowable amount, copayment (copay) and coinsurance impact how much you have to pay for medical services.
Because these can vary based on your insurance, contact your health insurance company to learn more. Use the phone number or website on the back of your insurance card.
Why do I get separate bills from Eye Surgery Center of San Francisco and the doctors?
Eye Surgery Center of San Francisco, as a facility, will submit billing includes charges for services or procedures received in our outpatient center. These charges may include costs for a room, medications, technicians, nursing, equipment, or administration.
What is doctor billing?
Doctor billing includes charges for healthcare services provided by a doctor or other healthcare professional. This includes professional assessment, direction and oversight. These services may be provided at facilities such as a hospital, surgery center or medical office.
Why did I get a facility bill and a doctor bill?
When you receive both facility and healthcare services, you often get two or more bills. Although our center and the doctor may use the same code or language to describe each charge, their bills are for separate services.
Can I get a price estimate for medical services?
There are multiple ways to receive price estimates, visit our patient resources page about insurance and billing for more information.
I made a payment. Why don’t I see it reflected on my statement?
This may happen due to a delay between the time your paper statement was generated and when it arrives at your home. The payment you made will still apply and will be reflected on your next bill.
If you have questions or would like to confirm that your payment was applied correctly, please contact your billing office by calling (415) 440-1100, Option 5.
What if my insurance denied a service of coding?
Each medical service corresponds to a procedure (CPT) code. Your doctor or healthcare provider selects this code based on your surgery. Sometimes your insurance company may say the code is wrong and suggest it be changed. Mistakes sometimes happen, so please call your doctor or healthcare provider to check that the procedure code is correct.
How do I contact Eye Surgery Center of San Francisco with questions about billing, payment or insurance?
If you have any questions about your bill, payment or insurance, call us at (415) 440-1100, choose Option 5. When you speak to a billing specialist or agent, we will ask you to confirm your identity. This helps to protect your privacy.