Insurance & Billing Information

We believe healthcare should be accessible and transparent. This page explains our insurance policies, billing practices, and payment options.

Accepted Insurance Plans

We're in-network with most major insurance carriers and accept the following plans:

Blue Cross Blue Shield
Aetna
United Healthcare/UMR
Cigna
Medicare

Not Sure About Your Coverage?

Insurance can be confusing! Our Billing Manager, Lisa Sorensen, is the go-to person for all billing and insurance questions.

Option 1: Call Us Phone: (224) 442-1230 Our staff will verify your coverage, check copays, and explain your benefits.

Option 2: Check Your Insurance Card Look for:

Insurance company name
Your member ID number
Group number (if you have employer-sponsored insurance)
Customer service phone number

Call the customer service number on your card and ask:

"Is Sarah Lazarski, NP an in-network provider?"
"What's my copay for primary care visits?"
"Do I need a referral?"
"What's my deductible status?"

Option 3: Check Your Insurance Company's Website Most insurers have online provider directories where you can search for "Sarah Lazarski NP".

Understanding Your Benefits

Copays

A copay is a fixed amount you pay at each visit. Common copays for primary care range from $15-50.

When do I pay my copay? At check-in before your appointment.

What if I don't know my copay? We'll verify it when you schedule, but you can also call your insurance company.

Deductibles

A deductible is the amount you must pay out-of-pocket before your insurance begins covering services.

Example: If you have a $1,500 deductible and haven't met it yet, you'll pay the full cost of visits until you reach $1,500 for the year.

Good news: Many preventive services (like annual physicals) are covered at 100% even if you haven't met your deductible.

Coinsurance

After meeting your deductible, coinsurance is the percentage you pay for services. For example, with 80/20 coinsurance, your insurance pays 80% and you pay 20%.

Out-of-Pocket Maximum

This is the most you'll pay in a year. Once you reach this amount, your insurance covers 100% of covered services for the rest of the year.

Self-Pay / Uninsured Patients

Don't have insurance? We offer self-pay rates for uninsured patients.

Self-Pay Visit Fees:

New Patient Visit $125
Follow up visit $80.

Lab work and imaging are billed separately.

Billing Process

How billing works:

Visit Date: You pay your copay at check-in
Insurance Filing: We file your claim electronically (usually within 24-48 hours)
Insurance Processing: Your insurance processes the claim (typically 2-4 weeks)
Explanation of Benefits: You receive an EOB from your insurance showing what they paid
Final Bill: If you owe any balance after insurance, we'll send you a statement
Payment: You pay any remaining balance by the due date

Timeline: Most claims are processed within 30 days, though some may take longer depending on your insurance company.

What You'll Pay

At Your Visit:

Copay (if your plan requires one)
Any previous outstanding balances

After Insurance Processes:

Deductible amounts (if not yet met)
Coinsurance percentages
Any non-covered services

You'll never be surprised by a bill. We verify insurance before your visit and will discuss costs if we anticipate any significant out-of-pocket expenses.

Payment Methods

We accept:

Cash
Personal checks
Credit cards: Visa, MasterCard, Discover, American Express
Debit cards
HSA (Health Savings Account) cards
FSA (Flexible Spending Account) cards
Zelle

Online bill pay available through the patient portal for your convenience.

Common Billing Questions

Q: Why did I receive a bill if I have insurance? A: You may owe your deductible, coinsurance, or copay. Check your Explanation of Benefits (EOB) from your insurance to see what they paid and what your responsibility is.

Q: Can you tell me exactly what my visit will cost? A: We can give you an estimate based on your insurance benefits, but final costs depend on what services are provided during your visit. We're happy to discuss costs before any expensive procedures or tests. Ultimately, your insurance company decides what portion of services are paid by you. Concerns about coverage should be addressed with your insurance prior to the visit.

Q: What if I can't afford my bill? A: Please call us at (224) 442-1230. We offer payment plans and may be able to work with you on financial arrangements.

Q: Do you accept payment plans? A: Yes, for balances over $100, we can arrange monthly payment plans. Contact our billing department to set this up.

Q: How long do I have to pay my bill? A: Payment is due within 30 days of the statement date. If you need more time, please contact us before the due date.

Q: What if my insurance denies my claim? A: We'll work with you and your insurance company to resolve denied claims. Often denials are due to missing information that can be corrected.

Q: Can I get an itemized bill? A: Absolutely. Call our office and we'll provide a detailed breakdown of all charges.

Insurance Authorization & Referrals

Prior Authorization: Some insurance plans require prior authorization for certain services. We'll handle this process for you when needed. Common services requiring authorization: