Start with your specific plan
When you call, have the full name of your insurance plan available. Ask the office about participation for the service you need and whether a referral is required. Benefits and requirements can differ even between plans from the same insurer.
Before a procedure
- Does the plan require prior authorization?
- What deductible, coinsurance or copayment applies?
- Are the surgeon, facility and anesthesia providers covered by my plan?
- Could pathology or laboratory services produce a separate bill?
- Who can provide an estimate for each part of care?
If you are paying directly
Ask the office about the consultation charge and how estimates for a proposed procedure are arranged. The surgeon’s charge may be separate from facility, anesthesia, pathology and other services.
Need help getting started?
The office can help identify the next questions to ask. Contact ALAGSA before your appointment if you are unsure about referral or coverage requirements.