top of page

The Practice of Michael D. Randell, MD is dedicated to providing you with the highest quality, cost effective gynecological care. Because we are a solo, boutique, concierge practice and not a large group or hospital owned practice, our prices may be less than other medical practices.  We accept all commercial insurance plans that pay benefits for our services, cash, MasterCard, Visa, cashier's check, and money order.  We offer discounts to patients without insurance or patients without out-of-network insurance benefits.  For patients looking for guidance in selecting an insurance plan, we suggest Aetna, Coventry, Anthem, or Meritain Health.  Our patients seem to be very satisified with these plans.

INSURANCE & PAYMENTS

Insurance: 

 

We accept all insurance plans that pay benefits for our services, but we are not contracted with all insurance companies. Rest assured that we do not balance bill patients*.  In other words, our promise to you is that you will never receive a bill from us for the difference between what you are required to pay and what your insurance company pays on your claim (unless your insurance company sends the payment directly to you for more than what you paid the Practice).  We understand that insurance is complicated and our goal is to make the payment process simple and to avoid surprise charges.

 

Payment is due when services are provided in the office and before any procedure is performed in the hospital.  The estimated amount due is determined by your insurance plan, not by us, and is subject to your benefit plan documents and any contractual terms that may exist.  Out of network benefits may apply in some cases where we do not have a contract with your insurance network.

 

In the event that your insurance company sends payment directly to you for services we provided, we request that you forward the payment to us as is required by your contract with your insurance company.  We will then issue any refund that may be due.

 

Although we may not be contracted with certain plans or networks, most hospital and other providers' services, separate from our services, will be covered at the in-network benefit level.  This provides you with significant additional savings to receive our world-class care.  All of our surgeries are performed at Emory Saint Joseph's Hospital which is in-network with most insurance plans. Click on this link to see a list of all insurance plans that are in-network.

In some cases, depending on your remaining deductible amount, we may be able to assist you with the cost of your care. 

Additional Fees: 

 

There are additional nominal fees charged to patients for copying medical records, completing forms, no-show appointments, same day cancellations, and non-covered services.  There is also an Administrative Service Fee and Surgical Assistant Fee charged for surgeries. *We reserve the right to balance bill patients if accounts are left unpaid and/or if insurance payments are not sent to the Practice. 

Insurance Preauthorization: 

 

A preauthorization is a decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.  A preauthorization is only a statement of medical necessity, not a guarantee of payment. Payment is based on benefits in effect at the time services are provided. While the Practice will attempt to obtain any required preauthorization, the Practice is not responsible should an insurance company deny a preauthorization request.

For more information about insurance or the cost of your care

contact our office at

404-250-4443

No Surprises Act

We are committed to helping you navigate issues that govern your physical and financial health. There are two new laws that may impact healthcare billing: the Georgia Surprise Billing Consumer Protection Act (a Georgia state law) and the No Surprises Act (a federal law), and their respective implementing regulations. Pursuant to the No Surprises Act, certain disclosures are provided below.

  • When you receive emergency care or are treated by certain out-of-network providers at an in-network hospital or ambulatory surgical center, you have protection from surprise billing.

  • What is “surprise billing”? When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may also have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

  • “Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

  • “Surprise billing” is a balance bill where a patient did not have notice that treatment was being rendered by an out-of-network provider. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

bottom of page