Insurance & Billing
Your procedure at Pavilion Surgery Center, an Ambulatory Surgery Center, will involve a number of separate and distinct services that will be billed to your insurance.
- Pavilion Surgery Center Facility Fee
- Surgeon/Physician Fee
- Assistant Surgeon/Physician Assistant Fee (if applicable)
- Anesthesia Fee (If applicable)
- Lab/Pathology Fee (If Applicable)
Your insurance plan may have different coverage levels for different services. For example, you may be responsible for paying your physician a co-pay for his/her professional fees for surgery. In addition to the physician co-pay, you may also have a facility co-pay. Payment is expected at the time of service.
Co-insurance is a percentage of the procedure charges (e.g., insurance plan pays 80% and you pay 20%), subject to your plan’s coverage limits. You may owe co-insurance to either the physician or surgery center or both. Also be aware that co-insurance may be in addition to your co-pay. Payment is expected at the time of service.
You may also have an annual deductible amount that must be met by you prior to any payment of services by your insurance. In this case, you may have both an annual deductible and co-insurance that is your responsibility. Payment is expected at the time of service.
Every insurance plan is different. You may have a co-pay, co-insurance, and deductible or some combination of the three. It is your responsibility to understand your plan and benefits – we can help. Prior to your procedure, you will receive a call from Pavilion Surgery Center’s partners at Sovereign Healthcare. We will verify your insurance and give you an estimate of your patient responsibility, based on what your physician has scheduled. The amount that is quoted to you is based on Pavilion Surgery Center’s contracted rate with your insurance. Your estimated patient responsibility is due at the time of service.
Before Your Procedure
Now that your procedure has been scheduled you will receive a call from Pavilion Surgery Center’s partners at Sovereign Healthcare to discuss your procedure. Since we’ve already verified your insurance benefits, this call will be to confirm the information we received from your insurance company and physician’s office is correct and to let you know what your co-pay/co-insurance payment/deductible amount will be on the day of your procedure. If you don’t have a copay/co-insurance payment due, or if you have secondary insurance, then you may not have any payment due on the day of your procedure.
Day of Your Procedure
Please remember to bring all insurance cards and other pertinent documents with you on the day of surgery so that we may process your insurance papers for you. We accept American Express, Visa, and MasterCard with credit card approval on the date of payment.
For more information regarding payment options, visit our Payment page.