Frequently Asked Questions from Patients
- 1. Who is True North Medical Billing LLC?
- True North Medical Billing contracts with surgical assistants nationwide submitting medical claims to your insurance agency on their behalf. We process and submit medical claims to insurance companies and send statements to patients for the portion that the insurance company stated is their responsibility.
- 2. What is a surgical assistant?
- The American College of Surgeons defines it this way: “Under the direct supervision of the surgeon, [the surgical assistants] provide aid in exposure, hemostasis, assist during surgery and in the preoperative and postoperative periods and other technical functions that will help the surgeon to perform a safe operation with optimal results for the patient.
Surgical Assistants have the following responsibilities: - 3. Why am I getting a bill from you?
- After submitting and reviewing the claim, your insurance company has determined that you are responsible for the amount in your statement; Not to exceed the allowable amount based on the explanation of benefits. This includes deductible, co-pay, co-insurance; as well self-pay or uninsured. Your payment should be made out to the surgical assistant provider's business or company for your procedure.
- 4. Why did my surgeon need to use a surgical assistant?
- After reviewing your medical health and history and the surgical procedure that was to be performed, your surgeon determined that a surgical assistant was medically necessary.
- 5. Why didn’t my surgeon tell me beforehand he was going to use an assistant? Moreover, why do I have to pay for a surgical assistant when I did not authorize this?
- The hospital has a legal responsibility to inform you about any physical or fiduciary risks that arise from your operation. It does this in a “surgical consent form,”which is given to you prior to surgery. This form typically gives surgeons the discretion to bring in one or more certified assistants to assist before, during, and after your surgery – depending on your particular needs. Keep in mind that if you were unable to make these decisions, they may have been made for you by the healthcare provider based on exigent circumstances. Hospitals are required by law to treat first and bill later.
See the following pages for more information:
Wikipedia article page on Informed Consent Informed Consent in the Operating Room (University of Washington School of Medicine) - 6. Why did my surgeon use a provider not in my network?
- Sometimes claims are denied because your insurance plan refuses to reimburse an out of network assistant. Your doctor, not the insurance company, is the one that chooses the assistant – and he or she bases this decision not on whether the assistant is in the network or not, but whether the assistant is available and has the skills to perform a safe and accurate procedure. If your insurance claim is denied because the provider was out of network, you may want to strongly consider appealing their determination. Your state legislature may offer you additional protections.
- 7. Did you bill my insurance?
- We usually receive insurance information directly from your provider from the hospital where you had your surgery. If the information is complete, we will use that information to send a claim to your insurance carrier in a timely manner, and avoid any delays in the payment of your bill.
- 8. Will you file a review or appeal to my insurer if the charges are denied?
- If your insurance denies the provider reimbursement for the services of a surgical assistant, we automatically appeal the claim if applicable. (Not every case is appealable.) You receive a bill when we’ve exhausted all of our options. We may possibly be able to do more once you formally appeal to your insurance provider. Keep in mind that you’re the one paying the premiums, and your position holds great weight in your dealings with them.
- 9. Do you offer payment plans?
- Yes! Please call us at 615-523-9626 and we’ll set something up that fits your budget.
Surgical Assistants have the following responsibilities:
- Assist in moving and positioning of patient.
- Drape patient within surgeon’s guidelines.
- Maintain the integrity of sterile field.
- Clamp, ligate, and cut tissue per surgeon’s directive.
- Close all wound layers (fascia, subcutaneous and skin) as per surgeon’s directive.
- Insert drainage tubes per surgeon’s directive, select and apply wound dressings.
- Assist with resuscitation of patient during cardiac arrest or other life-threatening events in the operating room.
- Perform any other duties related to the surgical procedure deemed necessary and as directed by the surgeon.
- Assist in maintaining hemostasis by direct pressure, use and application of appropriate surgical instrument for the task, placement of ties, placement of suture ligatures, application of hemostatic agents, or other measures as directed by the surgeon including the use of mono and bipolar electro-cautery.
- Provide retraction of tissue and organs for optimal visualization with regard to tissue type and appropriate retraction instrument and/or technique.
Contact Info
- 615-523-9626
- 615-346-9258
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If you have any questions, feel free to talk to us. True north medical billing is the quantum molecular structure of medical billing. Providers are the core nucleus in which TNMB revolves. You are the structure that makes us.