Q: How do I find out if FVSS surgeons are “in plan providers” for my insurance company?
A: The best thing to do is call your insurance company and ask. If you have access to a computer, check under your insurance company’s “provider directory.” FVSS surgeons are providers for many commercial and governmental insurance plans.

Q: Do I have to pay my copay?
A: Yes, you do. When you come in to see our surgeons for treatment, you will be asked to pay your copay at that time. We accept cash, checks and these credit cards: VISA, MasterCard, Discover and American Express. It is also important to check to see if your insurance plan requires a different copay amount to see a surgical specialist. Fox Valley Surgical Specialists is a specialty clinic.

Q: How can I find out how much my surgery will cost?
A: Once you and your surgeon decide surgery is necessary, we would be happy to explain all of the possible costs involved with your inpatient or outpatient surgery. It would also be important for you to call your insurance company to determine what your out of pocket expenses might be and whether you have met your deductible for the year. You can visit our FVSS Business Office on the campus at Theda Care Regional Medical Center – Appleton or call 920.731.8289 Monday – Friday, 8:30 a.m. – 5:00 p.m. to obtain this information and have all of your questions answered.

Q: What is a surgical assistant? Why are they important to my surgery?
A: Fox Valley Surgical Specialists employs Nurse Practitioners, Physician Assistants and Certified Surgical Technicians. These highly skilled practitioners work closely with our surgeons and are integral members of the operating room team. You will notice a charge for their services on your bill because your physician requires their assistance in surgery. Please call with any questions.

Q: What do I do if I don’t have insurance?
A: Fox Valley Surgical Specialists provides a 20% discount for patients without insurance. Payment plans are available when requested.

Please be aware that Fox Valley Surgical Specialists is an independent clinic and not part of ThedaCare or Affinity Health Systems. These health systems have charitable financial assistance programs that may be able to help with your hospital charges. Your surgeon’s bill is not included in these assistance programs and payment arrangements must be made.

Q: Do I need a referral to see one of your doctors?
A: It is very important to understand your individual insurance policy and its requirements. Please take the time to review your plan or call your insurance company to find out if a referral is necessary to see a surgical specialist at FVSS.

Q: I don’t understand my bill, who can I talk to?
A: Fox Valley Surgical’s Business Office is available Monday through Friday, from 8:30 a.m.-5:00 p.m. The phone number is 920.731.8289. If you call after business hours, please feel free to leave a confidential message and we will return your call the next business day.

Q: Why am I getting separate bills from my surgeon and the hospital?
A: Fox Valley Surgical Specialists will charge only for the services our surgeons and surgical assistants perform. The hospital will bill for the facility fees such as the hospital equipment and supplies used during your surgery, use of the facility, nursing care and medications.

Q: I have a Worker’s Compensation claim, what information do you need from me?
A: To file a charge to your Worker’s Compensation carrier or employer, we will need additional information at the time of your first visit. Bring the following information to your visit:

• Full name of employer, address and phone number
• Date of injury
• Name of Worker’s Compensation carrier, contact person and phone number
• Claim number that was assigned by your Worker’s Compensation carrier

Also, bring your health insurance information should your claim be denied by Worker’s Compensation.

Q: My insurance denied my claim, now what do I do?
A: Many times, insurance companies will deny a claim for an unclear reason. Please call your insurance company first to determine the problem, then call our office to discuss the issues. Every insurance company has its own process for reviewing denied claims. We will do our best to make sure we have made every attempt to get your denied claims paid properly.

Q: Am I responsible for obtaining authorization for my surgical procedure?
A: You are responsible for notifying your insurance company prior to having any surgical procedure performed. Fox Valley Surgical Specialists will obtain authorization for surgeries requiring a hospital stay (in-patient surgery).

Q: Who files my insurance for office visits and/or surgical procedures?
A: Please remember your insurance policy is a contract between you and your insurance company. As a courtesy to you, we will file your insurance claim after your visit or surgical procedure. Please be aware there is a time limit on how long we have to file insurance claims. If we miss the deadline because you did not provide us with the correct information, you will be responsible for payment in full. If you are filing a Worker’s Compensation claim, or you have had an accident, please bring all your filing information with you or call 920.731.8131 with the name of the insurance company, claim number and date of injury.