Insurance Matters

Coping with the stress and anxiety of cancer is more burden than anyone should have to bear. But when that burden is compounded with financial concerns, it can be overwhelming. At Cancer Treatment Centers of America, we strive to heal the whole person. This includes simplifying the financial aspects of treatment and making the entire process as efficient and uncomplicated as possible.

Types of Insurance Accepted at CTCA

Cancer Treatment Centers of America (CTCA) accepts many insurance providers. The best way to understand your insurance benefits at CTCA is to have them verified by an Oncology Information Specialist. Feel free to contact an Oncology Information Specialist at CTCA at 1-800-615-3055 to have someone help you with your insurance questions.

Physician Referrals

Some insurance companies, such as HMO's and PPO's, may require a letter of referral from your primary care physician to receive certain types of treatment or increased benefit levels under the plan. In the event a referral is needed, it usually must meet the following criteria:

• Written on insurance company letterhead (computer print screens are not acceptable)
• Includes all authorized approval signatures
• Specifies the facility (name and tax id #) where the patient will receive services
• Specifies the physician or physician group (name and tax id #) who will treat the patient
• Details the services that are approved (i.e. evaluation, testing, treatment)
• Indicates the specific dates for which the referral is valid
• Indicates any special billing instructions
• Coverage amount for professional services (i.e. physician, surgeon, anesthesia)
• Precertification requirements
• Total (lifetime) dollar amount of coverage your plan provides

Costs Not Covered by Insurance

You will be financially responsible for any deductibles, coinsurance and charges deemed by your insurance company to be in excess of Reasonable and Customary (R&C) and Usual and Customary (U&C) allowances. As a patient of CTCA you will be assigned a Patient Accounts Representative who is trained to assist you with insurance, billing and payment related issues.

Determining Your Insurance Benefit Coverage

The coverage provisions of every insurance plan - even the best plans - are very complicated. The Insurance Verification process is designed to provide both you and CTCA with a general understanding of your health insurance benefits as provided to CTCA by your insurance company.

The Insurance Verification Process

The Insurance Verification process gives you the financial information you need to make important decisions about your cancer treatment. Your Oncology Information Specialist will review the general coverage benefit levels that have been quoted by your insurance plan to CTCA's Trained Insurance Verifiers. He or she will also explain these and other aspects of your plan:

• Amount and frequency of the deductible you are responsible for
• Percentage of coverage the plan pays after deductible has been met
• Percentage of co-pay you are responsible for
• Type of inpatient and outpatient benefits the plan covers

As this verification is not an insurance company's actual guarantee of benefits, CTCA encourages you to familiarize yourself with the benefit plan you chose and to contact your insurance company directly if you have any specific questions concerning your contract with them. Keep in mind, the insurance relationship is yours, not ours, and CTCA cannot affect your benefits.

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