"Alla is a lovely young lady. Very polite, courteous, and helpful. A true “friend”. It’s unusual in this day and age to find such pleasantness in a front desk medical practice. Angel, the technician, was also lovely, personable, and a joy. This practice makes getting a mammogram a lot less stressful. Thank you and keep up the good work."
Insurance & Billing
Office Policies | Insurance Participation List | FAQ
Office Policies
Our staff is happy to assist you with your insurance and billing questions. Before contacting us for an appointment, it’s a good idea to familiarize yourself with your health insurance plan benefits, including co-payments, authorization requirements and your deductible status.
If you have questions about your plan, call your insurance company’s customer service number that is listed on your identification card.
We are committed to providing you with the highest level of service from your medical visit to the billing cycle; we recognize that insurance benefits are often complicated and change frequently. Accurate insurance information along with the subscriber’s full information is essential for our insurance claim submission.
It is our policy to verify current insurance with you at every office visit. Please bring your insurance card and photo identification (we are contractually obligated to require this information by several insurance companies). Without this information your appointment is subject to being rescheduled.
Co-pays, Co-insurance, deductibles, and balances are collected at time of service. We accept cash, personal checks, MasterCard, Visa or Discover/Novus.
Statements are mailed monthly. They are based on insurance payments or denials and the accompanying Explanation Of Benefit statements. We appreciate prompt payment of any outstanding balances.
Insurance Participation List
Below is a list of our approved insurance carriers:
| Insurance Carrier | Type | Special Notifications |
|---|---|---|
| AETNA US HEALTHCARE | HMO/PPO/POS | |
| ANTHEM BCBS | HMO/PPO | WE DO NOT ACCEPT ANTHEM HEALTHKEEPERS PLUS |
| CAREFIRST NCA/FEDERAL | PPO | |
| CAREFIRST BLUECHOICE | HMO | PCP MUST BE LISTED ON THE INSURANCE CARD |
| CHAMP VA | ||
| CIGNA/GREATWEST | PPO/HMO | |
| HUMANA | ||
| COVENTRY HEALTH | ||
| KAISER PERMANENTE | ||
| MAMSI LIFE AND HEALTH | PPO | |
| MDIPA | PCP MUST BE LISTED ON THE INSURANCE CARD AND LOCATED IN VIRGINIA. RAD=NOVA | |
| MEDICARE / HIGHMARK | ||
| ONE HEALTH PLAN | PPO | |
| ONE NET | ||
| OPTIMUM CHOICE | PCP MUST BE LISTED ON THE INSURANCE CARD AND LOCATED IN VIRGINIA. RAD=NOVA | |
| PHCS/MULTIPLAN | PPO/POS | |
| RAILROAD MEDICARE | ||
| TRICARE STANDARD/CHAMPUS | ||
| TRICARE FOR LIFE | ||
| UNITED HEALTHCARE | HMO/PPO/POS | |
| VIRGINIA MEDICAID | WE DO NOT ACCEPT AMERIGROUP/FAMOUS/HEALTHKEEPERS PLUS |
Insurance and Billing FAQ
Q: Why do I have to give my insurance information each time I visit Ultrasound Associates?
A: It is important to provide your most current insurance information at each visit to ensure proper billing. Insurance plans often change information such as group numbers or PO Box numbers which, if not changed on the claim form, results in a claim denial. This can have serious financial consequences because many insurance companies also impose time limitations on submission of claims.
Q: What do I need to bring with me to my exam?
A: Please bring the order or request from your doctor. The doctor’s order ensures that we know precisely what type of procedure to perform, and to whom we should send the report. You will also need to bring your insurance card, photo ID, and be prepared to pay your co-pay and/or co-insurance and deductible at time of service.
Q: Will Ultrasound Associates bill my insurance?
A: Ultrasound Associates will submit the claim to participating insurance providers, provided we have a copy of your insurance card. All co-payments, co-insurances and deductibles are due on the day of your appointment. Please review Ultrasound Associates’ Insurance Participation List to confirm that we participate with your insurance company.
Q: What is a deductible?
A: A deductable is a set dollar amount, such as $250 or $500, which must be paid out-of-pocket each year before your insurance company will start paying your claims. A deductible can be set for either an individual or the family. Please contact your insurance company for your deductible amount.
Q: What is a co-payment?
A: A co-payment (co-pay) is cost-sharing whereby the patient typically pays a specified amount with each visit to the doctor or specialist (e.g., $25 per visit).
Q: What is co-insurance?
A: Co-insurance is usually a percentage and is the portion your insurance company does not cover. Please contact your insurance company for your co-insurance percentage.
Q: Is Ultrasound Associates able to verify if I am covered for my procedure?
A: No. Ultrasound Associates does not know each patient’s insurance plan benefits. It is recommended all patients verify coverage for the procedures ordered before their appointment.
Q: My insurance should have paid in full. Why am I being billed for a balance?
A: You should receive an “Explanation Of Benefits” statement from your insurance company showing the amount you are responsible for and the reason. Since we do not know your insurance benefits, we suggest you contact your insurance company if you have any questions. The member services phone number for your insurance should be listed on your insurance card.
Q: Why do I have to sign a financial responsibility waiver/consent form?
A: A waiver/consent form is required for certain procedures. Some insurance companies pay for procedures only if it is determined that the services are reasonable and necessary. Some procedures are medically necessary only if the patient has certain medical conditions. The Waiver or Consent form is to help patients decide if they want to receive certain procedures that have a likelihood of being denied. The patient will have financial responsibility for the testing if their insurance company denies payment.
Q: Can I pay my bill online?
A: Yes, please use our online bill pay form. Ultrasound Associates accepts Visa, Mastercard and Discover/Novus.
Q: What does it mean if my insurance company denied a claim for other insurance information?
A: Periodically each year many insurance companies will send you a Coordination Of Benefits (COB) form to inquire about another source of health insurance coverage. Until they receive the completed form, all of your claims will be denied. In cases such as this, you will become responsible for payment of the service if your insurance refuses to reprocess your claim.
Q: If my insurance company refuses to pay my claim and I have coverage, what should I do?
A: You should contact your Human Resources Department or the Plan Administrator if your insurance is through your employer. If your policy is not through an employer, or your employer cannot help and the insurance company continues to deny the claim, contact the Insurance Commissioner in your State:
Virginia: 800 552-7945 http://www.scc.virginia.gov/division/boi/webpages/boifilecomplaint.htm
Maryland: 800 492-6116 http://www.mdinsurance.state.md.us/sa/jsp/consumer/FileComplaint.jsp
DC: 202 727-8000 http://disb.dc.gov/disr/cwp/view,a,1299,Q,616101,disrNav,%7C32810%7C,.asp
A: Due to the privacy act, we cannot obtain your records. Your insurance company must request them directly from your referring physician.