Patient Billing

Insurance, payments & financial details

Billing & Payments

If your insurance requires a copayment, this is due at the time of your appointment. The Surgical Clinic accepts cash, check (payable to The Surgical Clinic, PLLC) Visa, MasterCard, American Express and Discover. Any co-payments, co-insurance or deductible payments are due at the time of service. If payment is not rendered at the time of the visit The Surgical Clinic reserves the right to collect all fees prior to your next scheduled appointment.

Once insurance claims are settled, patients will have 30 days to pay any remaining balances or to make arrangements for payments. Failure to do so provides The Surgical Clinic the right to contact a collection agency for collection of all unpaid balances and all fees accrued for this service will be added to the unpaid balance.

If you have questions regarding your account please call our billing office at 615-292-5722. Many times a simple telephone call can clear up any misunderstandings.

Insurance Coverage

It is important that you check with your insurance company prior to making your appointment with the Surgeon. The Surgical Clinic accepts most insurance coverage, but you will want to make sure that your specific policy is included. A call to your insurance company will provide you peace of mind that your procedure will be covered. The insurance specialists at The Surgical Clinic will file all office and surgical procedures with your insurance company. Make sure that you bring your most recent insurance cards and/or any changes to your plan coverage to EVERY appointment.

You can find a general listing of the insurance companies and Medicare and many HMO and PPO plans that work with The Surgical Clinic below.

2021 plans and networks at The Surgical Clinic in Middle Tennessee

Out of network Info

Please note that you are responsible for knowledge of your insurance benefits and are financially responsible for all non-covered services and all OUT OF NETWORK services that are NOT COVERED by your insurance plan.

Surgeons are considered to be ‘specialists’ by most insurance plans. This means that most insurance plans require a referral form from your primary care physician, nurse practitioner or physician assistant before you can have an office visit with a surgeon. Without this prior authorization, the surgeon will be unable to see you. You can make sure that your appointment goes smoothly by providing your referring doctor the name and fax number of the Surgeon you are planning to see at The Surgical Clinic. For a list of surgeon addresses and fax numbers click here.

Co-payments

If your insurance requires a copayment, this is due at the time of your appointment. The Surgical Clinic accepts cash, check (payable to The Surgical Clinic, PLLC) Visa, MasterCard, American Express and Discover. Any co-payments, co-insurance or deductible payments are due at the time of service. If payment is not rendered at the time of the visit The Surgical Clinic reserves the right to collect all fees prior to your next scheduled appointment.

Once insurance claims are settled, patients will have 30 days to pay any remaining balances or to make arrangements for payments. Failure to do so provides The Surgical Clinic the right to contact a collection agency for collection of all unpaid balances and all fees accrued for this service will be added to the unpaid balance.

If you have questions regarding your account please call our billing office at 615-292-5722. Many times a simple telephone call can clear up any misunderstandings.

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Estimate for surgery

A $650.00 deposit will be required prior to your surgery. A Financial Counselor can provide an estimate to you about the cost of your surgery. This is just an estimate and may not be the final cost.

Financial Assistance

Ask our Surgical Clinic Billing and Financial Counselor for payment options. We will be glad to help you! 
We take Cash, Checks, Money Orders and all Major Credit Cards.

Insured Patients

You must provide Proof of Insurance at your visit. Copays, deductibles and co-insurance are your responsibility. Your appointment may be rescheduled if not paid. If we are Out of Network with your insurance, you may be responsible for higher deductibles, copays and coinsurance.

Self-pay or uninsured

If you are self-pay (uninsured or we are Out of Network) a $250 deposit toward your office services is required the day of your first appointment at The Surgical Clinic. Your appointment may be rescheduled if not paid. 
If we are Out of Network with your insurance, you may be considered self-pay.

Self Pay

Self-Pay patients must talk to one of our Billing/Financial Counselors on payment policy & arrangements.

Some elective procedures or patients with self-pay coverage may not be covered by insurance and you will be expected to pay for your care by yourself. Self-Pay patients will be expected to pay the day’s charges on the day of the service. There may be additional charges for tests and other services rendered subsequent to your visit. If you are having a procedure done, you will be expected to make mutually agreeable payment arrangements prior to receiving the service.

Special Claims

Workers Comp
Auto Insurance
Legal Claims

If you are seeing a physician due to an automobile accident or other injury related to a legal claim or an injury sustained on the job (worker’s comp) against a third party, you must bring all related documents with you including; claim number, case management claim. We will not file a claim without this information, and you will then be considered a self-pay patient. 
Questions? Click here to call now, we’re glad to help!

Applications

DISABILITY, SSI/SSDI
Family Medical Leave
EXTRA INSURANCE FORMS

Please make sure that you bring any forms that you may want your doctor to fill out for things like applying for Disability Insurance, Social Security Disability (SSI/SSDI), Family Medical Leave (FMLA) or other types of Insurance Forms you are going to file (AFLAC or income replacement insurance). There is a charge for EACH Disability, FMLA or Insurance form that you ask the physician to fill out. You will want to fill out YOUR part of each of these forms before you arrive for your appointment.

Financial Policy

THE SURGICAL CLINIC
FINANCIAL POLICY
CLICK HERE

The Surgical Clinic would like to thank you for choosing us to provide healthcare to you and your family. We take Cash, Checks, Money Orders and all Major Credit Cards. 

Questions? Call 615.292.5722, Option 1. We will be glad to help you!

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