Billing & Insurance
Thank you for choosing Rochester Colon and Rectal Surgeons (RCRS). We strive to provide the best care possible. The following information outlines your financial responsibilities related to payment for professional services. Understanding how your healthcare services are paid for can be confusing. At Rochester Colon Rectal Surgeons (RCRS), our billing staff is happy to assist you with understanding the charges related to the medical services provided.
Health Insurance Plan Participation
Rochester Colon and Rectal Surgeons, P.C. participates with many plans some of the most major insurance plans such as Excellus BCBS, MVP, Aetna Health, United Health Care, Medicare and many other commercial insurance plans. We suggest that you please contact your insurance company to understand your in-network and out-of-network coverage.
If you have Medical Insurance Benefits, please bring your insurance card with you!
We participate and have contracts with most insurance plans, HMO’s, PPO’s, Medicare and other government agencies. Our business office will submit claims to these plans and will assist you in to help get your claims paid. If you change insurance plans, notify the office immediately.
If you have a secondary insurance we will automatically file a claim after the primary carrier has paid. Your insurance company may need certain information from you directly. It is your responsibility to comply with their request.
If a patient is a member of an insurance plan with which we do not participate, payment in full is due at the time of service. Before booking an appointment payment arrangements need to be set up prior with the billing office.
It is your responsibility to inform the office if you want a particular lab or imaging company selected. You may have a cost share difference we are unaware of and YOU are responsible to request we send your labs/xrays of your choosing.
It is the patient’s responsibility to provide all necessary information before leaving the office.
OFFICE VISITS: As part of your insurance contract, you are required to pay out of pocket until your deductible is met. Your insurance will be billed for services rendered and you will pay $75.00 at the time of service, and balance billed the remainder amount.
PROCEDURES/SURGERIES: the assigned dollar amount varies, feel free to inquire
Your insurance plan requires us to collect co-payments at the time of service. Waiver of co-payments may constitute fraud under state/federal law. Help us help you by paying your co-payment at each visit. We accept cash, checks, Visa, MasterCard and Discover.
You are responsible for a contracted percent (co-insurance) for all services, office visits, procedures, colonoscopy, etc. at RCRS. After your insurance has made a payment determination, you will be billed by RCRS for your financial responsibilities. You are also responsible for any balance remaining on your account for services rendered.
No Waiver of Patient Responsibility
It is the policy of the practice to treat all patients in an equitable fashion related to account balances. The practice will not waive, fail to collect, or discount co-payments, co-insurance, deductibles, or other patient financial responsibility in accordance with state and federal law, as well as insurance plans.
Non-Covered And Out Of Network Services
Payment for medical services that are considered by your insurance company to be non-covered, out of network, or not medically necessary will be your responsibility. We recommend that you verify your insurance coverage prior to treatment and fully understand the financial responsibility (out of pocket expenses) your policy sets forth.
If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If you fail to notify RCRS in a timely fashion you remain responsible for full incurred charges.
Services Billed Separately
Some of the services you may receive in conjunction with your care by Rochester Colon and Rectal Surgeons, P.C. are not included in the charges billed by RCRS; you may be billed separately for them. They include hospitals, ambulatory centers, x-rays, radiologists, labs and anesthesiologists. They may, or may not, participate with the same plans as Rochester Colon and Rectal Surgeons, P.C. Please check with those other providers if you have questions regarding the insurance plans they participate with or a bill you may receive from them.
Rochester Colon and Rectal Surgeons, P.C. is unable to provide specific information on fees for these separately billed services. RCRS is always available to provide specific information on our own fees, please ask our billing department.
Procedures are billed separately and in addition to office visits charges. Some insurance policies classify office procedures as “Surgery”. Office procedure (surgery) can incur additional co-payments or out of pocket expense as set by the insurance plan. In such cases, payment for the procedure will be due from the patient. We follow accepted billing guidelines; procedures performed are in your best interest.
As Colon rectal Specialist it is very likely that you are provider will perform a diagnostic procedure essential in managing your medical condition. These procedures are known as anoscopy, proctoscopy, and/or a flexible sigmoidoscopy. Your insurance carrier may define them as a “surgical procedure”. You explanation of benefits may reflect the use of this term and you may have additional co-payment or deductible charges for these procedures.
“POST OP” Global Period
Some office and/or surgery procedures have a “global period”. This means the fee for that service covers routine post-operative care for a limited number of days. However, if a different diagnosis is treated within that period, this is a separate billable service. In such situations, the normal co-payment/deductible must be rendered and full payment is your responsibility for care of this additional diagnosis.
Please let us know if you are having difficulty paying your account. We may be able to help you by setting up a payment plan based on your financial hardship, call 585-244-5670 option 4 for assistance. This could prevent you from being sent to collections prematurely.
Insurance Claim Processing
As a courtesy, we are happy to file your insurance claims. You can help us file these claims effectively by providing at the time of your office visit, a copy of your current insurance card and all necessary billing information.
Depending on your insurance plan, you may be required to make a co-payment or pay a deductible amount. Co-payments and a portion of your deductible are due at the time of service. Insurance payments made directly to Rochester Colon Rectal Surgeons will be applied to your account. If a balance remains, you will receive a billing statement.
We partner with the following organizations:
If You Do Not Have Medical Insurance
Payment for all professional services is expected at the time of your visit. Please note, we do offer payment plans and have adjusted fees for patients in financial hardship. Please contact the office for the fees for your visit.
Missed Appointments, No-Shows and Cancellations (All Patients)
Any patient who fails to arrive for a scheduled appointment without cancelling the appointment at least 2 business days prior to the scheduled time is considered a “no-show”. An office appointment no-show patient will be charged $75.00. Cancellation is required 4 business days prior to any colonoscopy and surgical procedures. Such a cancellation will be charged $150. A patient who no-show appointments are at risk of being dismissed from the Practice.
Any unpaid account balances including, but not limited to co-payments, co-insurances, and deductibles not paid by the insurance carrier; will be charged an administrative fee of $20 if not received at the time of service. Accounts not paid in full within 30 days will be subject to finance charge of up to 18% annually. Should an account become delinquent 90 days and referred to the collections agency; the patient is responsible for the balance owed plus all the costs incurred in collecting the balance.
Billing statements are sent out on a monthly basis. All charges are due and payable within 30 days of receipt. We accept the following methods of payment: cash, check, Visa, Master card, and money orders.
Thank you for understanding our financial policy. Please let us know if you have any questions or concerns.