General Fax Number: 201-857-1101
Fax Prescriptions: 201-815-2078
Fax Precertification Clinical: 888-760-5678
20 Franklin Turnpike
Waldwick, NJ 07463
Telephone: 201-445-8822

Medical Billing FAQ

Question: Can you bill Worker`s Compensation for my claim?

Answer: Yes, we normally can bill Worker`s Compensation, but we need this information: your social security number, the name of your employer, the date of injury, your Worker`s Compensation claim number and the name and address of the Worker`s Compensation carrier. (The carrier is usually your employer — in some states, it`s the Worker`s Compensation Commission.)

Question: How do I pay? 

Answer: By check, cashier’s check, money order, or credit card. For check or money order, send payment, along with your statement stub to the billing address on your statement. For Credit card payments, please call 201-445-3044

Question: I can’t figure out my statement. What does all this mean?

Answer: Most statements contain the same types of information – just in different places. Go to Account Information to see services and the insurance and billing activity that occurred for each of your services — and resulted in the due amount on your statement. If that doesn’t answer your questions, call the customer service number shown on your statement.

Question: I lost my job and can’t pay my bill, but I will when I can. Is there anything I can do to keep this from going to a collection agency?


Answer:
 Yes. Call us at the phone number shown on your statement. Ask if you can set up a payment plan to pay just a little bit each month. Then make the agreed payments. (This will go on our file.) If you don’t pay and don’t make arrangements, your account may go to a collection agency and this information may go on your credit report. Then you might be turned down for credit (not be able to get a loan to buy a house or car or get new credit cards) for the next several years.

Question: I moved. How do I update my address?

Answer: Send us a letter at the billing address on your statement or call 201-445-3044.

Question: If I paid the physician’s/specialist’s bill and my insurance paid the bill, will I receive a refund?


Answer:
 Once the physicians charge or health plan allowable is met, any overpayment on the account will be researched to determine if the patient is due a refund.

Question: I’ve changed insurance coverage. Do I need to tell my health care provider before my next visit?

Answer: You don’t need to notify your health care provider yet, but it would be a good idea to let us know about your new coverage so that we can file any claims you have with the appropriate insurance organization. If you wait, it could take longer to process a future claim.

Question: My insurance organization used some words I don’t understand to explain why they didn’t cover some of my expenses. Help!

Answer: Refer to the Glossary on this site. There you’ll find a short list of the most common medical billing terms. If your word isn’t there, look for it in your insurance policy and explanation materials. Or, call your insurance organization and ask for clarification.

Question: What’s this bill for? I don’t know what all these specialists do.

Answer: This bill is for radiology services including reading of the x-rays in the hospital setting. In some radiology cases, a pathologist’s bill is for interpreting the specimen sent to the laboratory

Question: When do I pay?

Answer: Please pay the amount due shown on your statement within 30 days of receiving your statement. If it reaches us after 30 days, it’s considered past due. If your statement shows a specific due date, send your payment in by that date.

Question: Why aren’t my treatment and diagnosis shown?

Answer: We don’t show treatment and diagnosis information because we handle only the billing portion of the medical process. If you have questions about your treatment, diagnosis or other medically-related questions, contact your health care provider.

Question: Why did I get multiple bills for the same procedure?

Answer: How you’re billed depends upon how your health care provider is set up for billing professional and technical services. Sometimes your health care provider bills for both and sometimes only for one part of the procedure. For instance, you may receive bills from the hospital, an anesthesiologist, a radiologist, a surgeon and your doctor – all for the same procedure.

Question: Why did I receive a bill from the hospital and the physician’s or specialist’s office?

Answer: The hospital bills you for the use of their facility and the supplies used during your stay. The physician or specialist bills you for services that you receive.

Question: Why did my insurance organization reject the claim?

Answer: There are many reasons why claims aren’t paid. (1) Your insurance organization might not have accurate information to process the claim. Compare insurance information on file with information on your insurance card. (2) If the information on file was correct, your insurance may have applied the amount to your deductible, your policy may not have covered your services, your insurance may not have been in effect, or your insurance organization may need more information to process your claim. Your insurance organization should’ve sent you an explanation of benefits that explains why they didn’t pay — and informed you if they need additional information.

Question: Why didn’t my insurance organization pay the entire bill?

Answer: There can be many reasons for this. For example, many insurance organizations have a specified amount that they pay per procedure regardless of what your physician charged. In some cases, you’re responsible for this difference. Other reasons could be: your procedure could have been an ineligible expense, your deductible may not have been met, you may have supplementary (secondary) insurance or you’re expected to pay a certain percentage or dollar amount of the cost.

Question: Why haven’t I received a bill yet?

Answer: The medical billing process is a complicated one. Many steps are taken between the time you receive medical services and when you get your bill. Your health care provider, your primary and secondary (if any) insurance and the billing office/agency work together to coordinate payment. To save time and money, you are not notified until all parties have reviewed and coordinated payment. This may take two or more months.

Question: Why is the amount paid less than the amount allowed?

Answer: Sometimes the insurance organization only allows a certain amount for a charge. When the health care provider accepts the payment, he or she agrees to that amount. For instance, a health care provider performs a service for $50. But Medicare only allows $40 for that service. The difference is $10, which is written off. Then Medicare pays 80% of the $40, which is $32. The secondary insurance or the patient pays the remaining $8.

Question: Why weren’t all my procedures shown on my statement?

Answer: Your other procedures may have been performed by a health care provider who doesn’t use this billing agency. Then, you’d receive a separate statement from him or her. Or, you may have been billed only for the part that has been resolved and determined to be your responsibility. In that case, you’ll receive a statement after charges for the other procedures have been reviewed and resolved. Please pay each statement promptly.

Question: Will you bill my primary insurance organization?

Answer: Yes, we’ll bill your primary insurance organization, but we need this information: your insurance organization’s name and address, your policy and group numbers and the policyholder’s name and employer. Please enter that information in Insurance Information on this site and we’ll file your claim.

Question: Will you bill my secondary insurance organization?

Answer: Yes, we’ll bill your secondary insurance organization, but we need this information: your insurance organization’s name and address, your policy and group numbers and the policyholder’s name and employer. Please enter that information in Insurance Information and we’ll file your claim.