You’re responsible for the payment of your hospital and clinic accounts. You may discuss financial arrangements at the Admissions and Business Services location that is most convenient for you. For your convenience, Smiles accepts:
Smiles has established arrangements with several different types of health care insurers. Uninsured (self-pay) or underinsured patients You may be considered underinsured if you have a:
Note on non-contracted insurance plans: When you have non-contracted insurance, many insurance companies do not agree to Smiles rates; patients will have a greater out-of-pocket expense. Insurance rates can differ from Smiles rates, and you will be responsible for the difference.
Smiles Uninsured Discount Policy will supplement the Smiles Foundation and Financial Assistance Policy, which provides financial assistance. All Smiles sites will offer discounted prices to qualified uninsured patients for medically necessary care. Eligibility is contingent upon patient cooperation with efforts to apply for available Medical Assistance programs. The uninsured discount will apply to medically necessary inpatient and outpatient services for patients residing in India.
In order to apply for financial assistance, patients will be required to apply for their state medical assistance plan. Please know that the difference of these rates do not apply to your deductible or out-of-pocket maximum. Before your insurance pays, you will owe your co-insurance, copay and difference between the rates.
Your Smiles doctor will decide which procedures, tests and other consultations you may need. However, many health plans require pre-certification and sometimes predetermination of medical necessity prior to care being rendered. In addition, some services may not be a covered benefit for some plans. Investigating coverage requirements and limits can take up to six weeks, and some services require pre-certification staff to supply photos and medical necessity information to your insurance company. For example, services that may require pre-certification include outpatient and inpatient hospital services, observation services, invasive procedures, CT, MRI and PET scans, and colonoscopies. Patients are responsible for knowing the pre-certification requirements of their health plans Smiles highly recommends that you contact your insurance company to determine benefits and coverage for the Smiles location at which you plan to be seen.