Does your insurance cover
your procedure?
Three questions. Plain answers. No hold music.
What procedure were you referred for?
Select the closest match — we can clarify on the next step.
“I expected a $40,000 bill and paid $1,200.”
— Margaret H., Aetna PPO, post-lobectomy
Every plan we accept, visible.
No guessing. No phone tag to find out if you're covered. If your plan isn't listed, call us — we verify within one business day.
Aetna
All Aetna PPO & HMO plans
Anthem Blue Cross
Including Blue Care Network
Blue Cross Blue Shield
Most BCBS state plans
Cigna
Open Access Plus & LocalPlus
Humana
HMO, PPO & Medicare Advantage
Kaiser Permanente
Referral required
Medicare
Parts A & B; supplement plans
Medicaid
State-administered; verify plan
UnitedHealthcare
Choice Plus, Navigate, Options PPO
Molina Healthcare
Marketplace & Medicaid plans
TRICARE
Active duty & retired military
Highmark
PA, WV, DE markets
“I was terrified Medicare wouldn't cover the VATS. The billing team confirmed in one call — fully covered.”
“Nobody told me I had secondary coverage. Thorax caught it and I paid nothing.”
Don't see your plan?
We'll call your insurer directly and verify within 24 hours.
“They called Aetna so I didn't have to.”
— Sandra M., VATS lobectomy, Aetna HMO
From referral to paid claim,
step by step.
Here is exactly what happens after your referring physician sends us your chart. No black boxes.
Referral Received
Your referring physician sends us a referral. Our team contacts you within 24 hours to confirm your appointment and collect insurance information.
We request: insurance card (front & back), photo ID, and referral letter.
Insurance Verification
Our billing team calls your insurer directly to verify in-network status, deductible remaining, out-of-pocket maximum, and any pre-authorization requirements.
We confirm: copay, coinsurance, deductible balance, and surgical facility coverage.
Pre-Authorization
For most procedures, we submit a prior authorization request on your behalf. We handle all clinical documentation and follow up with your insurer.
Average approval: 3–5 business days. Expedited available for urgent cases.
Cost Estimate Provided
You receive a written Good Faith Estimate before your procedure — a plain-language breakdown of expected costs based on your verified benefits.
No Surprises Act compliant. You sign off before we proceed.
Post-Surgery Billing
After your procedure, we submit claims directly to your insurer. You receive one consolidated bill — not separate invoices from multiple providers.
Questions? Our billing team responds within one business day.
“They called Aetna so I didn't have to. I got a callback the same afternoon with everything explained.”
“One bill. One phone number. That's it.”
Received an unexpected bill after surgery?
Our billing team will review your EOB with you line by line and dispute any incorrect charges directly with your insurer — at no cost to you.
“I was uninsured when I got my diagnosis.
We found a path anyway.”
— Thomas B., charity care patient
Cost should not determine
whether you get care.
Every patient who comes to us gets a financial review before any procedure is scheduled. Here are the programs available to you.
Sliding Scale Fee Reduction
Up to 80% reductionPatients with household income up to 400% of the federal poverty level may qualify for reduced fees based on a confidential financial review.
Interest-Free Payment Plans
0% interest, up to 24 monthsSpread your out-of-pocket balance over 6, 12, or 24 months with zero interest. No credit check required for balances under $5,000.
Charity Care Program
Up to 100% of charges forgivenUninsured or underinsured patients may qualify for full or partial forgiveness of charges through our Charity Care program, funded by the hospital foundation.
Medicare Supplement Assistance
Varies by programOur billing team helps Medicare patients identify supplemental coverage and apply for Medicare Savings Programs that reduce Part B premiums and cost-sharing.
Pharmaceutical Assistance
Up to $500/month on prescriptionsWe connect patients with manufacturer assistance programs for post-surgical medications, reducing prescription costs for uninsured and underinsured patients.
Emergency Financial Counseling
Personalized plan within 24 hoursSame-day financial counselor appointments available for patients facing urgent scheduling decisions due to cost concerns. No appointment needed.
“I was uninsured when I got my diagnosis. The financial counselor found me coverage and a charity care application in the same afternoon.”
“They set up a payment plan before I left the consultation. No paperwork, no waiting.”
Talk to a financial counselor today.
No judgment, no pressure. Our financial counselors are here to find every dollar of assistance you qualify for — before you make any decisions.
“I finally found a place that answered
in plain English.”
— Diane W., post-surgical billing dispute resolved
Questions we hear
at 2 in the morning.
Answered here, in plain language, without jargon. If your question isn't here, call us.
In-network means our practice has a negotiated rate agreement with your insurer. You pay the contracted rate (usually your copay + coinsurance) rather than the full billed charge. Important: both the surgeon AND the surgical facility must be in-network for you to receive in-network benefits. We verify both before scheduling.
The EOB 'patient responsibility' figure is the maximum you might owe — it includes your deductible, coinsurance, and copay combined. If you have already paid toward your deductible this year, your actual balance will be lower. Call our billing team at (800) 555-1234 and we will walk through your EOB line by line to determine your real out-of-pocket amount.
Claim denials are common and often reversible. Common reasons include: missing prior authorization, incorrect billing code, or out-of-network facility. Our billing team handles appeals on your behalf — we write the appeal letters, gather clinical documentation from the surgeon, and follow up with your insurer. We resolve approximately 78% of denied claims on first appeal.
Standard pre-authorization takes 3–5 business days after we submit the request. Urgent or emergency cases can be authorized within 24–48 hours. We submit the authorization request immediately upon receiving your referral and track its status daily. You will be notified as soon as approval is received.
You will receive one consolidated bill from our practice. However, if your procedure is performed at a hospital or surgical center, you may receive a separate facility fee bill from that location. We will tell you in advance exactly which bills to expect and from whom. Our billing team can help you understand and dispute any facility bills as well.
Medicare Part A covers inpatient hospital stays; Part B covers surgeon fees and outpatient procedures. Most thoracic surgeries are covered when medically necessary. If you have a Medicare Supplement (Medigap) plan, it typically covers your Part A and B cost-sharing, potentially reducing your out-of-pocket to zero. Medicare Advantage plans vary — we verify your specific plan's surgical benefits before scheduling.
Under the No Surprises Act, you have the right to receive a Good Faith Estimate before any scheduled service. This is a written itemized estimate of your expected charges. We provide this at least 3 business days before your procedure. If your final bill exceeds the estimate by more than $400, you have the right to dispute it — and we will help you do so.
Please tell us. We have multiple financial assistance pathways including sliding scale fee reductions, interest-free payment plans up to 24 months, and charity care for qualifying patients. No patient has been turned away for inability to pay. Contact our financial counselor at (800) 555-1234 before making any decisions about delaying care due to cost.
Still have questions?
“The hardest part was the diagnosis.
The billing was the easy part.”
— James W., Medicare patient, lobectomy 2025