Insurance and Billing
Pre-Certification:
Certain services may require pre-approval
from your health insurance company before they can be performed.
Before your visit to the Total Center or admission to the hospital
for surgery, review your health plan's booklet or call your
insurance company to clarify your policy benefits and requirements.
Your policy may vary from another subscriber insured by the same
company. It is important for you to be aware of your plan's
pre-certification requirements in order to receive the full
benefits allotted for services performed.
Our staff can help you obtain insurance
authorization/approval for services performed during your
evaluation at the Total Joint Center. However, pre-certification is
your responsibility. Prior authorization or predetermination can be
initiated by staff for procedures that your insurance company may
consider experimental, elective or cosmetic. This can take a
considerable amount of time (three to eight weeks) and often
requires medical-necessity information to be supplied to your
insurance company by the physician's staff.
Before scheduling a second-opinion
consultation at the Total Joint Center, you should address any
second-opinion requirements with your insurance company. The
insurance company can tell you if pre-certification is
required.
Plans That Require
Pre-certification
If your
insurance plan requires pre-certification for some testing or
procedures your Total Joint Center physician may order, it is your
responsibility to advise registration staff of those requirements.
If pre-certification is required, our staff will call your
insurance company or primary care physician (PCP) for approval if
necessary.
Pre-certification is not performed unless you
notify our registration staff to do so. If pre-certification was
required but not done, your benefits may be reduced or denied and
become your responsibility to pay in full.
Who to Contact with
Your Insurance and Billing Questions:
The hospital has a staff of Patient Financial
Advisors available to answer your questions about insurance and
billing. In addition, the Total Joint Center is available to assist
you.
Correspondence
Address:
Patient Financial Advisor
Office
Saint Francis Memorial Hospital
900 Hyde Street
San Francisco, CA 94109
(Please include your account/guarantor number
with correspondence.)
Payment
Address
(Facility or Hospital
charges only):
Saint Francis Memorial Hospital
P.O. Box 7726
San Francisco, CA 94120-9940