Astera Urology participates with most major insurance carriers, and we work diligently as your patient financial advocate in an effort to help you understand and access your benefits. Please contact your insurance carrier to confirm that we participate with them and be sure to bring your insurance card(s) every time you come to the office.

We Accept Most Insurance Plans

Our caring, knowledgeable team members will help you explore your insurance coverage and learn about your benefits. At Astera Urology, we work with most major insurance carriers. As participation varies by region and physician, we recommend that you contact either our office or your insurance company representative to verify that your insurance plan is accepted.

Cost Containment, Ethical billing practices & HIPAA-Compliant Confidentiality

For your peace of mind, Astera Urology maintains firm policies and procedures on cost containment and ethical billing practices. Operating in compliance with the Health Insurance Portability and Accountability Act (HIPAA), Astera Urology protects and secures your health information and privacy, ensuring that all of your information will remain confidential.

Insurance Copayments & Billable Amounts

As a participating provider with your insurance carrier, we are contractually obliged to collect copays at the time of service. Your insurance company may require copays, not only for office visits with your physician, but for injections and laboratory appointments. We must collect copays at the time of service for these visits, as well.

Upon completion of your visit and payment of your copay, Astera Urology will bill your insurance company for the remaining balance due. In the event you are unable to pay the copay at the time of your visit, we regret we will be unable to accommodate you and your appointment will need to be rescheduled.

Make sure you read your insurance plan documents. They can be hard to understand, so take your time and review them carefully. Talk with us if you have questions. You can also talk with your employer or the insurance company’s customer service representative.

Here is some basic but important information about out-of-pocket costs:

• Deductibles – Deductibles are the amount of money you pay before the insurance company starts paying their portion of a medical claim. For example, if your health insurance policy has a $250 deductible, you will have to pay $250 in covered expenses before the company picks up its portion. Usually, higher deductibles mean that you make a lower monthly payment for your premium.

• Co-payments – A co-payment (also called a “co-pay”) is a fixed fee the patient pays to the doctor or medical provider for each visit or service. Co-pays can be $5, $20, $35 or more. The insurance company sets the amount of the fee. You will make co-payments for office visits, emergency room visits, hospital admissions and other medical care.

• Co-insurance – After deductibles are met, the plan begins paying a percentage for your care. Whatever is left over is called “co-insurance.” This amount is paid by the patient.

 

What does “coordination of benefits” mean?

Sometimes people can be covered under more than one health insurance plan at a time. For example, a person may have Medicare coverage at the same time that their significant other has family coverage from a job. Health insurance companies have set up rules to decide which plan pays first and which plan pays next. This is called “coordination of benefits.”

Here are the basic rules about which plan pays first:

• For your health expenses, your plan pays before your significant other’s plan.

• The plan of the covered person who has the earliest birthday in the year pays first on children.

• If two insurance companies don’t agree on who pays first, the coverage that has been in effect the longest pays first.

Billing for out-of-network Insurance at Astera Urology

In the event that Astera Urology is not a participating provider with your insurance company, we will still forward your billing claims to your insurance company at the time of your visit. Solara will then bill you for any remaining charges not covered by your insurance company. You will be responsible for this remaining balance.

Patients without any insurance must be prepared to make a full payment at the time of service.

Responsibility for Referrals

If your insurance requires referrals, it is your responsibility to ensure the referral is either sent to our office prior to your visit or you may also bring it with you to your appointment. We suggest that you retain a copy so that you may keep track of the number of visits left on your referral and its expiration date.

Please feel free to ask Astera Urology to make a copy of your referral for you. We may have to reschedule your visit if you do not have a current referral on file.

Appointment Cancellations

If you are unable to make your appointment at Astera Urology, it is important to call us to cancel the appointment a minimum of 24 hours in advance. In the event you do not call us to cancel, we regret we must charge a fee, as we have reserved this time for you.

Astera Urology will bill patients on a monthly basis for the balance of charges not covered by their insurance companies. Astera Urology requests payment of any balance due within 60 days of the date of the Astera Urology bill.

After 60 days, balances due will be billed at a rate including an additional 1.5% interest fee per month. Astera Urology accepts payments in the form of cash, check or credit card.