Queens Surgical Center is a for-profit facility dedicated to providing physicians and patients with a safe and effective environment for the performance of procedures related to the diagnosis presented. The facility will bill an appropriate “facility fee” for the performance of procedures.

Physicians who use the facility, including anesthesiologists, will bill a separate “professional fee” to be paid directly to themselves. This fee has no relationship to the facility payment other than they are generated at the same procedure.

Billing, payment, collection, and participation with carriers may differ considerably between the facility and the physician involved in the procedures at the facility.

A professional attitude shall be used whenever communicating with patients and insurance companies regarding payment for services rendered. Appropriate staff will assure that the patient understands the implications of his insurance coverage, if any, and the resulting personal financial obligation and responsibility for payment for services rendered.

The world of health insurance has become increasingly confusing and complex for patients and physicians alike. For this reason, we would like to bring to your attention that we are legally required to bill you for any applicable co-payments or co-insurance and/or deductibles that your insurance plan requires you to personally pay under the terms of your insurance policy according to the opinion of the State of New York Insurance Department. For details, please see https://www.ins.state.ny.us/ogco2003/rq030409.htm.

The Federal and State governmental agencies that oversee the health insurance industry have consistently taken the position that the routine waiver of co-payments and co-insurance by healthcare providers may constitute insurance fraud by the insured and the physician. Within 6 months of receiving a response from your carrier, you will receive a “balance bill”. These amounts reflect that portion of our facility fees that were not paid by your insurance company and that remain as your personal responsibility. According to the State of New York Insurance Department opinion referenced above, a decision in the exercise of business judgment by a physician not to pursue the full legal remedies available to collect a debt would not constitute insurance fraud. If payment of your full outstanding balance is not financially feasible for you at this time, please call our office, and we will try to work out a mutually agreeable payment plan that you can afford to pay over a reasonable period of time.

For patients who have a sizable financial obligation after payment by insurance, or for patients who have no insurance coverage, a payment contract or the use of a credit card may offer the opportunity to satisfy the financial obligation. For those patients wishing to satisfy their balance due via a financial agreement, the patient or responsible party will be required to sign a contract prior to the procedure. The patient or responsible party will be given a copy of the signed agreement, and the original will be maintained by the Accounts Receivable Office.