How We Strive to Accommodate Your Financial Needs
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Even though we don’t accept health insurance plans, you are more than welcome to become a patient here if you have insurance. In fact, all patients are welcome to seek care at Trinity Heart and Vascular Group, regardless of their insurance status.
We understand that insurance needs vary from patient to patient, and so do financial needs. Patients who have a high-deductible insurance plan, are part of a cost-sharing program, or who are uninsured, will save money on cardiac testing when it’s performed at our facility.
However, we understand that paying cash prices for testing at our facility may not save you money if you:
- Have a low-deductible or no-deductible insurance plan
- Have a high-deductible plan where you’ve already met the deductible for the year, or
- Have Medicare or a Medicare Advantage plan.
If you meet one of those criteria (i.e., you have insurance that covers outpatient testing), we will work with you to make your healthcare as affordable as possible – even if that means referring you to a different facility for cardiovascular testing.
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Table of Contents
Our 'Hybrid' Approach
We want you to have the opportunity to make the best healthcare decisions and financial decisions for you and your family. In order to accommodate that need, we employ a ‘hybrid’ approach, where you can be a self-pay patient for office visits at our cardiology practice, and you can use your insurance for cardiac testing at another facility.
For example, if you want to see one of our providers for a detailed evaluation, you can pay our ‘cash-based’ price for a new-patient office visit, and we’ll help you determine the best course of action for your cardiovascular health issues.
If a cardiac test is needed, and you know that your insurance will cover the cost of that test, we can recommend a facility that will accept your insurance.
We have collegial relationships with many local, highly-qualified cardiovascular specialists who accept insurance, and we’re happy to refer you to them for testing that you’d like to submit through your insurance plan.
Here's How It Works
Step 1: After you receive your exam at our practice using the ‘self-pay’ method, we’ll refer you to a local, insurance-based practice for your testing, so that you can use your insurance.
Step 2: You’ll get your test done, and the insurance-based practice will submit a claim to your insurance for that test.
Step 3: We’ll request your test results, and contact you once we receive them.
Step 4: If necessary, a follow-up appointment will be scheduled at our practice, and you’ll only pay us for the follow-up appointment since your test was submitted through your insurance.
If you have Medicare, you will need to sign a private Medicare ‘Opt-Out’ contract. To learn more about the Medicare Opt-Out process, please click here.
Insurance Company Reimbursements
If your insurance company provides ‘out-of-network’ coverage, they may reimburse you for the medical services that you obtain at our facility since all of our providers are out-of-network.
If you want to be reimbursed directly by your insurance company, you may wish to call them to verify how much they will reimburse (it’s usually a percentage).**
While our practice does not communicate with insurance companies or submit claims for patients, we gladly provide paperwork that you can send to your insurance company. In order to be reimbursed, patients need to submit a receipt that contains ICD-10 and CPT codes.
These are insurance codes that correlate with specific types of medical exams, tests, procedures, and symptoms.
Any office visits and/or tests that you receive at Trinity Heart and Vascular Group (and pay for at the time of service) will be listed on the receipt, along with their corresponding ICD-10 and CPT codes. You can submit this to your insurance company, and work with them to meet their requirements for reimbursement.
We understand that this setup may not work for everyone, and we completely respect your choices when it comes to your healthcare and your finances. We’re grateful that you’re interested in our unique approach to cardiovascular care, and we’re here to help if you have any questions.
**If you are enrolled in a Medicare plan, Medicare cannot reimburse you for any services that you receive at Trinity Heart and Vascular Group, as we have opted out of Medicare. This means that our providers aren’t legally allowed to submit claims, and Medicare patients aren’t legally allowed to request reimbursements for any services rendered at our practice.
If you are willing to pay the cash price for our office visits (with the understanding that you cannot be reimbursed by Medicare), but you would prefer to have your cardiac tests submitted to Medicare, we will refer you to a facility that is legally contracted with Medicare plans, as explained in the ‘Hybrid Approach’ section above.
We gladly welcome Medicare patients, and hope that our hybrid approach can meet your needs if paying ‘cash’ for testing isn’t feasible. To learn more about the Medicare Opt Out Process, please click here.