Secure Horizon Direct Insurance: Understanding Your Coverage and Payment Responsibilities

When it comes to healthcare services, having a comprehensive understanding of your insurance coverage and payment responsibilities is crucial. At Atlantic Health System facilities, we strive to ensure that our patients receive the care they need while also managing their financial obligations effectively.

To start, please be aware that some insurance plans require pre-certification or pre-authorization for hospitalization, procedures, surgeries, or services before they can be provided. This is a common requirement for many managed care plans and insurance carriers, including Secure Horizon Direct Insurance. It is essential to verify this requirement with your insurance provider before admission.

In addition to obtaining pre-certification, it is also important to pay any deductible, coinsurance, and/or co-pay promptly. Your prompt payment will help us process your claim more efficiently and ensure that you receive timely coverage for your healthcare services.

Another crucial step in managing your insurance coverage is responding promptly to Coordination of Benefits (COB) requests from your insurance carrier. COB requests are used to determine which insurance plan should cover a particular service or procedure, and timely responses can help prevent delays in payment.

If your insurance claim is denied, please assist us in appealing the decision by providing additional information or documentation as needed. Insurance carriers frequently deny claims after 60 days, and late submissions may be considered patient responsibility. To avoid any confusion, it is essential to follow up with your insurance carrier or hospital if you have not received a bill or notice of payment within 45 days of service.

When receiving a bill from our facility, please verify the accuracy of the charges by comparing statements from us and your insurance carrier. If there are discrepancies, please contact our billing department immediately to resolve any issues.

Finally, be aware that most insurance carriers take 30-45 days to process claims after which we will seek your assistance in getting paid. If a claim is not paid within 75 days, the bill will be considered patient responsibility. At Atlantic Health System facilities, we are committed to providing high-quality healthcare services while also managing your financial obligations effectively.

As network participants with many insurance companies, including those part of the Health Care Exchange (Affordable Care Act), we understand the complexities of insurance coverage and payment responsibilities. By working together, we can ensure that you receive the care you need while also maintaining a clear understanding of your financial obligations.

If you have any questions or concerns regarding your Secure Horizon Direct Insurance coverage or payment responsibilities, please do not hesitate to contact our billing department for assistance. We are here to help you navigate the healthcare system with ease and provide you with the best possible care.

Secure horizon direct insurance