Patient Resources

One of our insurance verification specialists will contact you if there is an anticipated out-of-pocket expense associated with your planned procedure. Please realize charges for your procedure at PrecisionCare Surgery Center are separate from your surgeon’s charge as well as any anesthesiologist* and/or pathologist charges that may be incurred.

The estimated rate amount for out-of-network services is available upon your request. You may be responsible for co-insurance and deductibles not covered by your insurer. Please note that such estimates cannot account for unforeseen medical circumstances that may arise while the services are performed.

The Center’s business office staff may contact you to verify your insurance and identify any out-of-pocket expenses you may have. If you do not receive a call before noon the day prior to your procedure, please contact the office at 1-866-787-4426 ext. 115. This is also the number to call for all billing questions related to your surgical services at the surgery center.

In Network

Aenta, Aetna Medicare, Cigna, Emblem Health Commercial (GHI), Emblem Health Commercial (HIP), Emblem Health Medicare, Empire BCBS Commercial, Empire BCBS Medicare, Empire NYSHIP (effective 12/1/2023), Magnacare, Medicaid, Medicare (Part B), Multiplan, No-Fault, Oscar, Oxford (United Healthcare), United Healthcare (Commercial), United Healthcare Medicare, Worker’s Comp

Out of Network

Cigna Medicare, Empire BCBS Medicaid (Health plus), Fidelis, Healthfirst, Humana Medicare, Metroplus, WellCare

If your provider is not listed here, please contact our office at 631-380-2710 to confirm your provider

Copayment, deductible, and coinsurance are terms commonly used in health insurance to describe the financial responsibilities of policyholders when receiving healthcare services. Each of these terms represents a different aspect of how costs are shared between the insurance company and the insured individual.

Copayment (Co-pay)
A copayment, often referred to as a “co-pay,” is a fixed, predetermined amount of money that an individual must pay out-of-pocket at the time of receiving specific healthcare services, such as a doctor’s visit or prescription medication.

Copayments are typically stated as a specific dollar amount (e.g., $20 for a primary care doctor’s visit) and are due regardless of the total cost of the service. Insurance plans use copayments to help share the cost of healthcare expenses between the policyholder and the insurance company.

Deductible

A deductible is the initial amount of money that a policyholder must pay out-of-pocket for covered healthcare services before their insurance plan starts to pay a portion of the expenses.

Deductibles are usually specified as an annual amount (e.g., $1,000 per year). Until the policyholder meets or exceeds this deductible by paying for eligible medical expenses, they are responsible for the full cost of those services. After the deductible is met, the insurance plan typically covers a percentage of the remaining costs.

Coinsurance

Coinsurance is the percentage of healthcare costs that the policyholder is responsible for paying after meeting their deductible. Unlike copayments, which are fixed amounts, coinsurance represents a percentage of the total cost of covered services.

For example, if an insurance plan has a 20% coinsurance requirement and the total cost of a covered medical procedure is $1,000, the policyholder would be responsible for paying $200 (20% of $1,000), while the insurance company would cover the remaining $800.

Coinsurance helps share the cost of healthcare expenses beyond the deductible between the insurance company and the insured individual.

In summary, copayments involve fixed out-of-pocket payments for specific healthcare services, deductibles are the initial amount a policyholder must pay before insurance coverage kicks in, and coinsurance represents the percentage of costs shared between the policyholder and the insurance company after the deductible is met. These terms are important for individuals to understand when choosing and using health insurance plans.

To learn more, visit healthcare.gov.