Insurance Information and Cash Pricing For Hernia Repair
All insurances cover hernia consultations as well as hernia surgery if needed. Hernia treatment
is never considered 'cosmetic' or 'elective'. We have never had an insurance carrier deny a
consultation with our center.
We work with many patients who have either lost their insurance, or just don't have insurance right now. At
California Hernia Specialists we feel every patient should have the ability to obtain hernia surgery or
hernia repair regardless of their financial status. Our office
provides clear, up front, cash pricing for hernia patients without any hidden costs (see below).
Our Approach
We know medical billing and insurance can be confusing. Rest assured, our office staff works with patients every day to help them understand what costs, if any, may be required. No procedures or authorizations will be obtained without your direct input and knowledge. Plus, our office provides this service to our patients at no charge!
What Insurance Do You Accept?
At California Hernia Specialists we accept most insurances including all PPO insurances, Medicare, as well as a number of IPA's or managed care patients. We rarely have a patient that is not able to be seen at our center due to insurance. Patients are welcome to call our friendly office staff to help determine if we accept your insurance. If you prefer, you can include your insurance information on our 'Contact Us' form and our office will ensure you are covered for your consultation. Our insurance experts can perform a FREE, fast, easy, no obligation insurance verification to make sure you are covered for any consultations or a procedure at our center
Consultation Referrals and Insurance Coverage
Most insurance companies allow patients to self refer themselves for a hernia evaluation. If your insurance requires a referral or an authorization, our office is happy to help obtain that for you. At your consultation, our office staff will help you understand what benefits you have in case surgery is required. Most patients have only a small co-pay at the time of the consultation.
Surgery Coverage
Our office staff specializes in obtaining full authorization for any surgical procedures BEFORE you commit to having surgery. Our knowledgeable staff can walk you through what portions of your deductible have been met, what portions are still not met, and what costs you may be responsible for. Often patients will have only minimal out of pocket expenses. Regardless, we will ensure you understand any costs.
Uninsured patients: How Much Does Hernia Surgery Cost?
We work closely with patients who have lost their insurance recently or just don't have insurance at this time. In today's job climate, this is not an uncommon situation! Our office is happy to schedule you for a consultation with Dr. Harris without any further obligation.
If you decide to have surgery, the costs for patients without insurance are approximately $1500 for the surgeon fees, and $2000 for the surgery center fees (including the operating room time, all materials including mesh, and recovery), and $485 for the Anesthesiologists fee for a total of cost $3985.
We don't have any other hidden fees or other 'follow-up' visit charges. The only other charges that you may incur would be for pre-operative bloodwork, an EKG if needed, and for your pain medications after the surgery. Even these costs are usually very reasonable at a number of locations around our office or your home, which ever is more convenient.
Below is a short video in which Dr. Harris discusses the costs associated with hernia repair for patients without insurance.
Forms of Payment
Our office accepts most forms of payment. For any co-pays, cash, credit cards, or check may be used. For patients who must pay for a portion of the surgery out of pocket, those fees may need to be paid before the surgery via a cashier check, money order, or credit card. Patients without insurance and cash patients can work with our office to arrange payments before the procedure.
In-Network and Out-of-Network
Our office is in-network for almost all major insurances as described above. However, for a few insurances and a select number of patients, the surgery center within our facility may be 'out-of-network'. Our goal at California Hernia Specialists is to provide you specialty care within the constraints of your insurance.
If your insurance offers out-of-network benefits for your surgery, we prefer to schedule your procedure at our center. However, if you do not have out-of-network benefits, or your out of pocket requirement is too high, we will ALWAYS schedule your procedure where your costs will be the LEAST. Our insurance specialists will walk you through the process to ensure your out of pocket expenses are always minimized.
Every patient who has the option of out-of-network benefits will get a copy of the form shown here. This will outline the important costs associated with the surgery center charges.
Sample Patient Bill
Click HERE for a sample bill that might be sent to patients. Again, our staff is happy to review any parts of your bill and answer any questions.
Dr. Harris sees patients from all over Southern California, the greater US, and Canada. Our Newport Beach office is conveniently located in Central Orange County adjacent to John Wayne Airport between the 405, 73, and 55 highways.
Our office staff are experienced in verifying insurance coverage for each patient, as well as offering excellent pricing for patients without insurance (see costs above). We are happy to discuss all forms of payments with patients as needed.
