Important Financial Information for Our Patients

Dear Patient,

Thank you for choosing Advanced Reproductive Health Centers, Ltd. as your healthcare provider. You likely have presented your insurance information at registration and have elected to have us bill them for you. If we have not received a response from your insurance carrier, we may call upon you for assistance in obtaining payment. Once we have received notification from them, we will be sending you a statement for any remaining balance. We offer several payment options to help you with your balance remaining. We accept checks, money orders, cash and all major credit cards. You may pay at any ARHC office or over the telephone. We apologize for the inconvenience, but personal checks over $1000 must be certified or in money order form only when paying for advance pay treatment packages.

Based on the service provided, you may receive separate bills from ARHC, Ltd., anesthesiologist, and other professional specialists. Please contact these companies directly if you have any questions concerning their bill.

If you have any questions, please call our billing department during our normal business hours. Our Customer Service Representatives will be happy to assist you. When calling in regards to your account, please refer to your patient account number. Once again, thank you for choosing Advanced Reproductive Health Centers, Ltd.

How Does the Billing Process Work?

1. You present a valid insurance card to our Front Desk staff and sign forms giving us permission to bill your insurance.
2. You sign forms giving us instructions regarding your privacy wishes according to HIPPA Privacy Laws.
3. Verification of Benefits (VOB) is performed by our staff. We ask your insurance company about your coverage for general medical, gynecology, fertility testing and fertility treatment procedures. Please note the VOB is not a legally binding document and it is not a guarantee of payment. It is only a preliminary estimate of what is supposed to be covered.
4. Medical Service is given to you.
5. Your insurance is billed. This occurs the same day of service for office procedures and several days following surgical procedures.
6. EOB – You will receive an Explanation of Benefits (EOB). Our Billing Department will receive the same EOB. Payment is sent to us with our copy of the EOB. Denials, adjustments and other important information are recorded on the EOB. If you receive a check fro your insurance company, please call our office.
7. Payment Denials – If we believe payment can be expected from your insurance company, all denials are processed and re-submitted by our Billing Department within five business days. Please read your EOBs carefully for amounts that you may owe ARHC. For denials which we believe cannot be re-submitted, we do not re-submit claims.
8. Patient Invoice – After an EOB indicates how much you owe ARHC, you will receive a patient invoice from ARHC, Ltd. You will continue to receive these each month until your balance is zero. Please call our office to make payment arrangements.

What is a “Verification of Benefits” (VOB)?

At a minimal charge to you, ARHC staff will contact your insurance company. We will spend up to one hour to verify your benefits. Our staff will ask several dozen detailed questions about your insurance coverage. Please be aware that the VOB is not a legal document, and ARHC can not be responsible for the information provided by your insurance company. Final decisions for payment are between you and your insurance company.

What is an Explanation of Benefits (EOB)?

• An EOB is an important document – usually one page – which you receive from your insurance company when we submit a claim. We receive the identical EOB, typically with a check for payment. If the claim was denied, we receive only the EOB.
• EOBs will explain what amount was paid us and what amount you owe.
• EOBs will explain reasons for denials.
• EOBs will explain write-offs or adjustments or deductions to your balance that we may be required to take.

What papers should I keep?

• Copy of your insurance card
• Copy of your HIPPA Privacy form
• Copy of receipts/checks for all payments you give us
• Copy of all statements/invoices you receive for your care
• Copy of all letters you receive from your insurance company
• Copy of the VOB we perform, and
• Copy of any financial estimate letters we send you

How does ARHC Ltd. process paperwork?

Incoming Mail – Each item of mail or paperwork is carefully stamped/signed/processed into batches. These daily batches are kept for a number of years. Pages cannot be removed from these batches; therefore, important documents will not be lost.

Requests from your Insurance Company – All are numbered. Follow-up forms are attached to each insurance company request for medical records or other information. Since these are numbered and tracked, ARHC, Ltd. managers can supervise and be certain that your insurance items are processed within several days.

How much will my care cost?

Your exact out-of-pocket cost is difficult to determine. Your insurance plan may have co-pays, deductibles, and treatment exclusions.

ARHC, Ltd., by law, is expected to have a full price list. These prices are available by asking our staff. Each service given to you or any other patient is billed out at the exact same price, but payment to us differs greatly depending upon insurance contracts, co-pays, exclusions and deductibles.

Self-pay packages are given to you, in writing. These pre-set package fees do not change for patients. For more expensive services, such as IVF, you will receive a “patient financial estimate letter” before you undergo treatment. You are expected to read and sign the letter. Payment is expected, for self-pay packages, before treatment begins. If you are not able to pay in full, please contact our staff to make payment arrangements. Fees are subject to change without notice.

What if my insurance company denies payment?

• Claim denial will be stated on EOBs received by you and us.
• We automatically resubmit claims within five business days of denial. If it appears that you are responsible for the fees, we will send you a monthly invoice and contact you to make payment arrangements.
• You have the legal right to appeal all claims to your insurance company. Your insurance company must respond within 30 days.
• You have the right to file a claim with the Insurance Commissioner in the state in which you reside. Please ask our staff for this contact information.

What are my rights as a patient?

You have certain guaranteed rights. These rights protect you when you receive health care, assure your access to needed healthcare services, and protect you against unethical practices. Your rights include, but are not limited to:

• The right to privacy as set forth in HIPPA Privacy Laws;
• The right to information about what tests/services are covered and how much you will have to pay;
• The right to information about all treatment options available to you; and
• The right to appeal decisions to deny or limit payment for medical care.

What if my Insurance Company says that ARHC billed incorrectly or did not supply required documents?

ARHC files all office visit insurance claims the same day as your visit. We handle thousands of claims. Although it is not likely, errors can occur. We correct billing errors within five business days. Furthermore, all requests for additional information are processed within five business days.

On the other hand, it is very common for health insurance companies to claim the following:

• Incorrect billing from provider;
• Lost claims; and
• Lost paperwork.

Please contact our billing staff if any of the above should occur. We keep detailed records as to all activity on your account.

What if I have further questions?

For further information, please contact:

• ARCH Billing Department (ph. 847-966-8817)
• Illinois Department of Insurance
• American Society of Reproductive Medicine
• American Medical Association
• The American College of Obstetricians and Gynecologists

Our Mission Statement "...Exceeding patient expectations..."