• We know that health care insurance can be confusing. Please take a brief moment to review this page to help you understand some key points about your insurance as it relates to your procedure at Mountain Empire Surgery Center (MESC).
• MESC will give you an estimate of your portion of the cost of your procedure. This estimate is based on the procedure(s) your physician has scheduled and the type of insurance plan you have.
  It is important to know that this is only an estimate. Sometimes things change and additional or sometimes less procedures may be performed than was known when the surgeon scheduled your procedure. These changes can affect your final financial responsibility to MESC, either more or less.
  We expect payment prior to your surgery. Payments include your co-pays, coinsurance and any deductible amounts that are due.
• A copay is a form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is responsible for the rest of the reimbursement. There may be separate copayments for different services. Some plans require that a deductible first be met for some specific services before a copayment applies.
• A deductible is a fixed dollar amount during the benefit period (usually a year) that an insured person pays before the insurer starts to make payments for covered medical services. Plans may have both per individual and family deductibles. Some plans may have separate deductibles for specific services. For example, a plan may have a hospitalization deductible per admission. Deductibles may differ if services are received from an approved provider or if received from providers not on the approved list.
• Coinsurance is a form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount, if any, was paid. Once any deductible amount and coinsurance are paid, the insurer is responsible for the rest of the reimbursement for covered benefits up to allowed charges: the individual could also be responsible for any charges in excess of what the insurer determines to be “usual, customary and reasonable”. Coinsurance rates may differ if services are received from an approved provider (i.e., a provider with whom the insurer has a contract or an agreement specifying payment levels and other contract requirements) or if received by providers not on the approved list. In addition to overall coinsurance rates, rates may also differ for different types of services.

Billing Information

Because there are several healthcare practitioners who are providing a service to you, there will be separate bills generated from each of these providers; therefore, you can plan to expect bills from multiple providers for one procedure at our Surgery Center.

• Our bill is from Mountain Empire Surgery Center (MESC), which is the facility fee.
• You will also receive a bill from your anesthesia provider. The anesthesia providers at MESC are from Anesthesia and Pain Consultants and are a separate business from MESC. The anesthesia provider may or may not be on your insurance company’s panel of providers. While they are on most panels, they are not on all. If you have concerns about your coverage for anesthesia services, please contact them directly prior to your surgery. Their contact # is 423-283-0776.
• Your Doctor’s Office will generate a bill that will come from your Physician’s Group and is also a separate business from MESC.
• MESC will bill your procedure to your insurance company for their portion, and to a second insurance provider, if you have one.
• Additionally, in certain cases, you may receive a bill from a Medical Supply company. They provide specialized supplies that your surgeon has ordered for you such as crutches/slings etc.
• In the end, you are responsible for the charges associated with your procedure.
• If after the surgery, we discover that you have over paid us, we will issue you a refund.

Please refer to our Financial Policy for additional information. We are always here to help you in any way if you have questions or any kinds of financial concerns. Please call us at (423) 610-1020.