A GUIDE TO CHEM0THERAPY AND YOUR INSURANCE
The physicians and staff at Cancer Care & Hematology Specialists of Chicagoland understand that this is a difficult and stressful time for you and your family. Because we want you to be able to concentrate on what is most important –fighting your disease – our staff includes a Financial Counselor, who has been trained to answer your questions concerning insurance coverage if you should begin chemotherapy/radiation or require imaging services. Our Financial Counselor will verify your insurance benefits and meet with you to review the information obtained from your insurance carrier. Also, a statement of financial liability, if any, will be discussed with you at this time. An estimate of any financial liability will be provided.
Please take the time to carefully review how Cancer Care & Hematology Specialists of Chicagoland will partner with you in understanding your financial responsibility.
Cancer Care & Hematology Specialist's physicians are participating providers
with Medicare, accept assignment on all covered claims and will file claims
to Medicare on your behalf. If you have a secondary (supplemental)
insurance, these claims will also be filed to your secondary insurance.
Medicare requires you to pay the 20% co-pay and your annual deducible.
Medicare’s reimbursement for chemotherapy drugs is based on the diagnosis
being treated. If we suspect that Medicare may not cover part of your
treatment for your diagnosis, you will be asked to sign an Advanced
Beneficiary Notification, which will indicate that you have been informed of
the possible non-coverage. The Financial Counselor will work with you to
find alternative sources of reimbursement for that part of your treatment that
is not covered. Examples may include the use of a secondary insurance
prescription plan or a drug company’s patient assistance program.
Cancer Care & Hematology Specialist's physicians are
participating providers with the Illinois Department of Public Aid (IDPA).
Claims will be filed to IDPA on your behalf with a valid IDPA card that shows
your eligibility. A valid IDPA card must be presented at the time of service.
Services not covered by IDPA, such as spend down amounts, are your
responsibility and payment is expected at the time of service.
Cancer Care & Hematology Specialists participates in a number of health
plans. Before you come in for your appointment, please verify that your plan
is one in which we participate. Also, please make sure that diagnostic
testing will be covered and what facility those tests should be directed to (e.g.
Quest Laboratory).
Your HMO/PPO/POS plan will require that you pay a co-pay:
* When you see your physician
* When you have chemotherapy
* When you have a port flush
Some plans may also require a co-pay for lab services, injections, CAT and
PET scans. Pleas consult your plan for coverage.
Your HMO/PPO/POS plan may have specific requirements for referrals to see
a physician and for diagnostic testing. Please refer to your insurance plan for
those requirements. Patients are responsible for ensuring that they present
with a valid referral for covered services. Should you begin treatment, we
will assist you in obtaining referrals for the duration of your treatment. Once
treatment has been completed, you will again become responsible for
obtaining referrals for any follow up visits.
- Commercial/Indemnity Plans
Cancer Care & Hematology Specialists accepts all commercial and indemnity
insurance plans. Generally, these plans have an annual deductible and an
out of pocket expense up to a certain dollar amount based on the plan. The
out of pocket expense and the deductible is the payment responsibility of the
patient.
Any questions concerning your billing statement can be answered by the staff
at our Central Billing Office, (847) 585-7000. Representatives are available
Monday through Friday from 8:00 a.m. to 4:30 p.m. After 4:30 p.m., there is an
answering service that will take your message. Your call will be returned the
next business day.