This section of our website addresses the charges for the services provided by our medical practice. While we provide this information to comply with federal regulations, healthcare billing is complex. It is extremely important for you, as the consumer, to understand that standard charges may not be a relevant starting point for estimating what costs you may incur during an episode of care. Furthermore, the amount actually paid by a patient will depend on that patient’s insurance coverage, policy provisions and other factors. Each individual’s case is different based on that patient’s medical condition.
Please contact us at 919.341.0915 for more information regarding your specific financial responsibility.
Our general billing policies are as follows:
- Dr. MacPhee is not in network with any insurance companies.
- All patients will pay the surgeon fee at least two (2) weeks in advance of the procedure.
- For insured patients: Your real-time insurance benefits are applied to expected costs to determine the amount you are responsible for paying after insurance.
- For uninsured patients: Your out-of-pocket costs are based on a discount for the amount generally billed for services.
Why costs may vary:
Many factors affect the cost of health care services. The cost estimates provided may be different from your actual costs for several reasons, including but not limited to:
- The medical services/treatment you receive will be based on decisions made by you or your health care provider and may be different from the services you selected while using the price estimator tool.
- The medical service/treatment you receive may be impacted by complications, secondary conditions, and/or other unknown factors.
- The location of where your services are administered differs from what is selected during the estimation process.
- Your year-to-date benefit information may change from the time at which you receive this estimate and the time at which you receive care.
- You have a unique insurance plan design that is not currently supported.
Your insurance carrier can help you understand insurance terms such as out-of-pocket maximums, deductibles and copayments that will affect what you ultimately pay. Patients enrolled in Medicare can find insurance information at www.Medicare.gov.
Nothing on this site guarantees eligibility, coverage or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage information from your healthcare insurance carrier.
Please keep in mind, cost estimates are not a guarantee of payment or benefits. Again, the estimates are based on the contract rates/fee schedule with your insurance carrier. Your actual cost may be higher or lower than the estimate for various reasons. You will be responsible for the cost of procedures or services not covered by your insurance plan.
