Frequently Asked Billing Questions
Will my insurance cover screening breast ultrasound or tomosynthesis/3D imaging?
Most insurances cover these services. Please call our billing department or your insurance company to verify the benefits of your health plan.
Does the New York State Breast Screening Law cover my services?
Simply, you will be covered if your insurance company follows the NYS breast screening law and your insurance company states the services are medically necessary.
However, the NYS breast screening law does not apply to insurances outside of NYS, although any state can choose to follow the NYS breast screening law. Currently, the following states AR, AZ,CA, GA, IL, MI NC, PA, WA, MA, MI, CO, PA and CA DO NOT follow this law as well as Anthem. The back of your insurance card will list the state where your insurance company is located. Medicare, Medicaid and NYS self-funded plans are not required to participate.
The NYS breast screening law eliminates any cost-share (copays and deductibles) by the patient for diagnostic breast imaging procedures such as diagnostic mammogram, breast ultrasound and breast MRI when your insurance policy is through a participating NYS plan and services are deemed as medically necessary.
Please verify your coverage with either the EWBC billing department or your insurance company.
This was my screening/annual mammogram. Why am I being billed?
A screening mammogram by definition is two sets of images of each breast (craniocaudal and mediolateral oblique). Occasionally additional views are ordered by the radiologist to determine a diagnosis. These additional images are considered diagnostic and applied to your deductible and/or co-insurance plan.
I thought this was a “covered” procedure.
The term “covered” means that your insurance recognizes the procedure but does not necessarily mean they will pay for the service. You are responsible for your deductible and/or your co-insurance.
Coverage varies from one insurance plan to another, along with the services performed, and your individual risk factors or medical situation.
Can you send me an itemized statement?
Yes, we can post to your patient portal, mail or email based on your preference. Please call our Billing Department at (585) 442-1830.
No Surprises Act (Suprise Medical Bill) | Good Faith Estimate
Why do I have to pay at the time of service if my insurance company says to submit it first?
It is the policy of Elizabeth Wende Breast Care to collect payment at time of service. We will submit the claim to your insurance. We will promptly refund any overpayments.