Frequently Asked Questions

Q.  Where is Pacific Heights Surgery Center?
A.  We are located at 3000 California Street, the cross-street is  Baker.  Please click on the link for more details: Parking Information.

Q.  What time should I arrive for my surgery?
A.  The Surgeon’s office will tell you what time to arrive for your surgery. Typically, patients are asked to arrive 60 – 90 minutes prior to your procedure start time.

Q. What time is my surgery?
A.  Your surgeon’s office will tell you what time your surgery is scheduled.  The schedule is subject to change up until the day before surgery.  If you have not received your scheduled surgery time, please contact the surgeon’s office.  Pacific Heights Surgery Center does not give out surgery schedule times.

Q. What is the cost of my surgery?
A.  The cost for surgery varies depending on your insurance.  You will be contacted by mail or phone by our billing office (Medbridge) prior to surgery.  If you have any questions, please do not hesitate to contact Medbridge by phone at: 1-888-282-7472.

Q.  How can I pay my bill?
A.  If you have a co-pay, our billing office will contact you.  Payment is due on the day of surgery, unless you have paid prior to the day of surgery.  We accept  Visa, Master Card, American Express, Discover, cash or checks.

Q.  Why did I receive three bills?
A.  For every surgery there is a facility fee (PHSC), Surgeon’s fee (your surgeon) and an Anesthesia fee.  This occurs whether your surgery is performed at a hospital or a surgery center.  We will only collect the facility fee, you will receive separate bills from your Surgeon and Anesthesiologist.
 
Q.  Is Anesthesia “in-network”?
A.  If you are approved for surgery at our facility, then Anesthesia will be considered “in-network”.  If you have any concerns, please contact the anesthesia providers, NCAP at: 858-244-1058.

Q.  What is an EOB? 
EOB stands for ” Explanation of Benefits”. Health insurers send an Explanation of Benefits, or EOB, to their covered members after they or other family members receive healthcare services.  THIS IS NOT A BILL.  If you receive an EOB, bring it into your surgeon’s office, and they can review it with you.

Out-of-Network Policy

Our policy regarding billing patients for “out-of-network” surgeries is based on two central principles:

  • Providing certainty to the patient, and
  • Ensuring collection by the surgery center.

Your insurance carrier might refer to our surgery center as an “out-of-network” facility. This does not mean that we do not accept your insurance, but it does mean we do not currently have a contract with your particular health insurer. However, if you have an insurance policy with out-of-network benefits (e.g., a PPO policy), you have the additional benefit of visiting physicians and surgical facilities that are outside of your insurance carrier’s network, such as our surgery center.

We choose to stay out-of-network with certain insurance companies to maintain flexibility in optimizing your treatment. By staying out-of-network, we can tailor our processes to suit our surgeons, the surgeries performed here, and, most importantly, our patients. We are pleased to enter into contracts with insurance companies if it is in the best interests of the surgery center’s patients and medical staff.   Of course, contracted rates need to match or exceed our competition’s pricing in the marketplace.  (We generally consider our competition to be the local hospital outpatient departments.)

Our surgery center may choose to remain out-of-network with a specific insurance company because the insurance company cannot or will not offer contracted rates that compare well with those of our competitors. However, we do not want our patients to be financially harmed by our status as an out-of-network provider. For that reason, in determining what to charge a patient who has out-of-network insurance, we try to adjust the patient’s portion of the payment to compare to what the patient might pay in-network. We are able to provide these discounts because we collect at least 50% of the payment on or before the date of service. This comes at a risk to us, since we agree to perform the services without knowing what the insurance company will ultimately pay us.

So, if you are a patient with out-of-network insurance benefits, in most circumstances* we can offer you the following at our surgery center:

  • The certainty of knowing, before your surgery, what you will pay;
  • A discounted cost to you that is reasonably based upon your in-network benefits – so long as you pay at least 50% of that amount on or before your surgery date; and
  • The assurance that if you pay 100% on your surgery date, you will never receive another bill from us.

This policy is based upon both our concern for patients’ best interests and our need to make sound business decisions. First, we consider our relationships with our patients to be the highest priority. We endeavor to give our patients assurances about the amount they will owe when they come for service at our surgery centers.  Navigating the insurance process is daunting and confusing, and we are committed to helping our patients avoid the stress of these unknowns.

Additionally, we understand that when patients are billed for medical care after they receive service, they are 50% less likely to pay their responsibility.   Therefore, we offer incentives for the patient to pay before, or on, the date the patient receives service, which increases the likelihood of receiving payment and reduces the overall cost of health care by eliminating the need for collections and follow-up with the patient.

We are happy to answer any questions you may have. Please call the MedBridge Patient Services Department at 855-633-2743 M-F 8am-5pm. This is a toll-free number, so it won’t cost you anything to call.

*To be eligible, you must be insured, in good standing with your insurance carrier, and your claim must not be denied. Other exceptions may apply.