BILLING

Dr. J. J. Wendel Plastic Surgery would like to welcome you to our facility. For reconstructive plastic surgery, as a service to you, our office makes every reasonable effort to obtain payment according to your insurance coverage. Regardless of the type of insurance coverage you have, you are ultimately responsible for paying your medical bills. If you are a new patient you will need to bring a picture ID and insurance card. Before insurance companies can be billed for the services provided to you, you will be registered in our system to include, name, date of birth, social security number, address, phone number(s), insurance carrier and policy number. It is extremely important that this information is kept up-to-date. Accordingly, at each subsequent visit, the front desk will verify most of this information when you present for your appointment. Our office is available to assist you any time during normal business hours.

AUTO INSURANCE & THIRD PARTY LIABILITY INSURANCE

Dr. J. J. Wendel Plastic Surgery does not bill any automobile or third-party insurance. You are responsible for paying the cost of the health care services we provide to you. We will bill you directly and look to you for payment. You will need to settle with your automobile insurance or third party liability carrier separately.

BILLING QUESTIONS

Questions or concerns regarding your account or insurance claim should be directed to our office. Highly-trained experts in insurance billing have been instructed to make every effort to clarify any misunderstanding or confusion you may have concerning your account, (615) 921-2111.

Q: What do I do if my name, address or phone number changes or I have new Insurance?

A: Please contact our office at (615) 921-2100 to make these changes.

Q: If I have insurance, do I need to pay anything at time of service?

A: You are required by your insurance plan to pay any co-payment, co-insurance, or deductible that is due at time of service. We are required by our contract with your insurance plan to collect these payments.

BILLING STATEMENTS

Our statements include charges billed, the payments and adjustments related to those charges. These statements will reflect an amount due from you as well as a balance due from your insurance company. Patients with a personal balance will receive a monthly statement showing the specific amounts due. Patient balances are due upon receipt. Upon receipt of your statement if you are unable to make payment in full please contact our billing office to make payment arrangements. If you have any questions or concerns please contact our billing office, (615) 921-2111. If the patient is 18 years of age or older, that patient will be responsible for his or her own account; therefore, she or he will receive her or his own statement even if the 18 year old is still covered under her or his parent’s insurance.

CHARGES

Q: Why does my statement say I am responsible for a charge over the “usual, customary and reasonable” when my insurance company states that I am not responsible for anything?

A: “Usual, customary, and reasonable” is defined differently by each insurance company and may have little to do with cost of providing care in this area and is often ill-defined. If your insurance company is not fully covering the charges for your care from Dr. J. J. Wendel Plastic Surgery and is listing the service as a “non-covered service”, you are considered responsible for those charges. This also applies if your insurance is considered “out-of-network.

HEALTH INSURANCE

If you will be using health insurance to settle your account, you must present your current insurance card at each visit. This is a requirement of your insurance company. It also enables us to have the most current information to bill your insurance company. You are required by your insurance plan to pay any co-payment, co-insurance, or deductible that is due at time of service. We are required by our contract with your insurance plan to collect these payments. Dr. J. J. Wendel Plastic Surgery has agreements with several insurance companies, which require us to bill them for services provided to you, and accept as payment the amount specified in the agreement. You will be responsible for all amounts not paid by them, including amounts denied, applied to deductible, or considered non-covered as permitted by your insurance company.

We will file an initial claim based upon the information that you have provided to us. Under state law, your insurance company has 30 days in which to process and pay the claim, request more information, or deny the claim and notify us of the decision. If they have not notified us within 90 days of the date of service, it will be assumed that your insurance coverage is no longer in force and the unpaid balance will be your responsibility.

If you believe that your claims have been processed incorrectly please contact your insurance carrier and our billing office to discuss.

Q: How do I know if you accept my Insurance?

A: Please contact the customer service phone number listed on the back of your insurance card. This will ensure the most up to date information. You may also contact our office directly, (615) 921-2100.

Q: Do you file my insurance claims?

A: Dr. J. J. Wendel Plastic Surgery will file Primary, Secondary, and Tertiary major medical insurance on your behalf if we are a participating provider with your insurance carrier.

PAST DUE ACCOUNTS

Past-due accounts cost both time and money; therefore, patients with delinquent accounts will be required to make payment and/or payment arrangements.

Seriously past due accounts – those older than 90 days or those failing to honor agreed-upon payment terms – will be sent to a collection agency. If your account is sent to a collection agency you must pay all collection agency fees, plus any fees associated with the collection of this account. Additionally, patients can be dismissed from our practice for financial matters and will have to seek their health care elsewhere.

PAYMENT FOR SERVICES

Payment for services provided to you is ultimately your responsibility. For your convenience, we accept cash, Visa, Master Card, Discover and American Express. In addition, if you have health insurance, we will gladly file a claim on your behalf.

Q:  Do you offer payment plans?

A: Yes, payment plan programs are offered through Care Credit and M-Lend.  Please visit our payment plan page for more details, click here.

SELF-PAY

All New Self Pay patients will be required to make a deposit of $95 to $150 before being seen by any of our providers.

If you are self-pay, you will be expected to pay the day’s charges on the day of the service. When you pay at time of service you will be given a discount on eligible services. There may be additional charges for tests and other services rendered subsequent to your visit. You will be billed for these items. If you are having a surgery, you will be expected to make mutually agreeable payment arrangements prior to receiving the service. If the service is considered elective, payment must be made in full prior to the services being performed.

Note: We do not fill out FMLA and/or disability forms for cosmetic plastic surgery.

WORKER’S COMPENSATION

Our physician provides services under worker’s compensation plans. If you need to see a physician for an injury related to your employment, please have your employer or workers compensation case manager make the appointment. You will need to provide us with the case number, date of injury and the address to which the bill is to be sent.