About Us:

Financial/Insurance Information


Thank you for choosing Coastal Women's Healthcare as your OB/GYN provider. We are committed to providing you with quality and affordable health care.

Insurance Information

At Coastal Women’s Healthcare, we accept and participate in many insurance plans/networks (see list below). Many plans require that you make a co-payment at the time of your visit. For your convenience, we accept cash, checks, Master Card and VISA. Please be prepared with your insurance card and co-pay at the time of your visit.

If you do not see your Health Plan on our list, please contact your insurance company. Your Health Plan may contract through another insurer that is on our list.

Accepted Health Plans and Insurance Providers

Payment

For all services provided by the physicians and staff of Coastal Women’s Healthcare, payment is due at the time of service. This includes your portion that insurance will not pay including any co-pay, deductible and co-insurance amounts.

We accept Visa and Master Card. We do not accept post-dated checks. Returned checks are subject to a $25 service charge and may terminate your privilege to pay by check at future visits.

Collection Process

QUESTIONS: Thank you for taking the time to read our financial policy. We hope this answers some of your questions. If you have any other questions, please call our Business Office at (207) 885-8400. We are here to help!

Disability Information

Women who have recently had a baby or surgery, and will be out of work for a period of time due to these reasons, may be eligible for State of Maine Disability or Family Medical Leave Act (FMLA). You may want to check with your Human Resources Department regarding your eligibility for FMLA.

Steps to Take

To file for Disability Benefits, you may obtain the necessary forms from your employer’s Human Resources Department or Personnel Office. Bring these forms to our office two-three weeks before your due date or surgery date. Please do not give these forms to your doctor; you may leave them for the Referral Specialist.

Filling Out the Forms

If you require our office to complete any forms for disability or work purposes, there will be a $10.00 charge to be collected prior to the form being completed. It is important that you fill out the portion indicated for “Claimant Information.”

For pregnant patients, once you have delivered your baby, you should receive a supplementary form from your insurance company. Please bring or send that form to our office so we can update the information we have already given them (i.e. actual delivery date and type of delivery).

In the event your disability needs to be extended, a note from your provider will be mailed to you, which you must then forward to your employer. You need to be aware that if your insurance company does not agree with our medical opinion for the extension, you may not be paid.

The insurance company typically covers:

Additionally, if you had a baby boy and he had a circumcision, please call or send a note to our office with his full name, insurance company to include contract number and the name of the subscriber on the contract. Please make sure you have contacted the insurance company and added the baby to your contract. Most insurance companies require that your baby is added to the contract within 30 days. If this is not done, you may be responsible for the baby’s bill and any payments denied.

If you have any questions, you may call our office and ask to speak with the Referral Specialist. We are here to help.


Insurance Glossary

Health Maintenance Organization (HMO)

An HMO is any organization that provides delivery of health maintenance, usually through a specified medical group. A Primary Care Provider (PCP) manages all specialist referrals with the exception of OB/GYN services.

Preferred Provider Organization (PPO)

A PPO is a health delivery system consisting of a panel of providers that offer their services at a discounted rate. PPO’s do not require a primary care physician. They do require that the patient see a participating physician to receive the discounted rate. If a patient elects to see a non-participating physician, she may be responsible for a larger portion of the bill.

Point of Service (POS)

The patient may use this plan like an HMO or PPO and be able to choose their health care providers. With the HMO option, the patient is responsible for a co-payment. With the PPO option, the patient may have a deductible and no co-payment.

Co-insurance

Co-insurance is a requirement under a health insurance policy where the patient is responsible for a portion of the cost of covered services. (Example: The insurance company may be required to pay 80% leaving the subscriber to pay 20% as co-insurance. Usually the health insurance policy provides that the insurer reimburses a specified percentage of the covered services after deductible.)

Deductible

A deductible is a fixed amount that a patient contributes in payment for medical services during a specified period. (Example: The insurer policy may state that the patient has a $200 deductible per year. The first $200 in services billed to the insurance company would be denied a reimbursement, as the deductible is the patient’s responsibility.)

Co-payment

Co-payment is a provision under a health insurance policy where the patient assumes a fixed amount of the costs of covered services such as a $20 co-payment per office visit.

Exclusions

Exclusion is a specific condition not covered or service not paid for under a health insurance contract. Typical exclusions may be cosmetic or elective surgery.