Our staff is very knowledgeable about many insurance plans, but it is impossible to know the specific details of every plan.  One of the goals of our Billing Department is to prevent you from experiencing any unnecessary financial penalties associated with non-compliance with your insurance restrictions.  Insurance benefit verification will be performed for all patients, other than patients with Medicare or HMO-type insurance.

Medicare Patients:

The physicians of Hinsdale Hematology Oncology Associates are Medicare Participating Providers and accept assignment for all services.  We also participate in certain Medicare Advantage and Fee-For-Service Medicare Plans.

HMO, PPO and POS Patients:

You are responsible for obtaining any required referrals from your Primary Care Physician for each visit.  Our Referral Coordinator also obtains referrals on your behalf for limited and specific services, on a case by case basis.

Network Participation:

The Hinsdale Hematology Oncology Physicians participate with the following plans:

Payment of Services:

Patients are expected to pay any co-pay/encounter fee at the time of a qualifying service.  Services performed by our nurse-practitioners, nurses, or laboratory may result in a copay, depending on your specific insurance plan.

Payment for initial consultation service for non-Medicare patients may be requested at the time of service, depending on whether or not you have not met your yearly insurance deductible or if we do not participate with your insurance plan.

Prior Creditable Coverage for Waiving Pre-existing Conditions

A Certificate of Creditable Coverage indicates the length of time you have been continuously covered under a qualifying previous healthcare plan and allows waiver of any waiting period related to a pre-existing condition.  A Certificate of Creditable Coverage can be obtained from your previous Insurance Company.

If you have a new insurance with a Pre-Existing Condition Waiting Clause, and you have a condition for which you sought medical care prior to the inception of the new insurance, you will need to take action to have your pre-existing condition waived.

Steps to Waive Pre-existing Condition Clause

1.      Obtain your letter(s) of creditable coverage from your prior employer(s), depending on length of employment with last employer.

2.      Contact the new insurance and find out how and where to submit your letter(s) of creditable coverage for waiving of any applicable pre-existing conditions.  Get the full name and phone number of who is helping you, in order to follow-up.

3.      After the document(s) is sent or faxed, follow-up with your contact person in approximately ten days to make sure your record has been updated.

4.      Request that the insurance company reprocess any claims that are unpaid.