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Form analysis
1 forms found in the DOM

Name: paymentProcessForm — POST /FirstPay/paymentInfoProcess.action

<form name="paymentProcessForm" method="post" action="/FirstPay/paymentInfoProcess.action" id="paymentProcessForm"><input type="hidden" name="org.apache.struts.taglib.html.TOKEN" value="3821e51ee2bb858952d0ae8541dc471c">
  <input type="hidden" name="invoiceDetails.patientName" value="" id="patientName">
  <input type="hidden" name="invoiceDetails.patientId" value="" id="patientId">
  <input type="hidden" name="textingAuditId" value="217521" id="textingAuditId">
  <input type="hidden" name="invoiceDetails.jobCode" value="" id="jobCode">
  <input type="hidden" name="invoiceDetails.jobName" value="" id="jobName">
  <input type="hidden" name="addNoteInsInfo" value="" id="addNoteInsInfo">
  <input type="hidden" name="invoiceDetails.paymentAmount" value="" id="paymentAmount">
  <input type="hidden" name="invoiceDetails.totalAmountDue" value="" id="totalAmountDue">
  <input type="hidden" name="invoiceDetails.paymentType" value="CC" id="CC">
  <input type="hidden" name="primaryInsName" value="" id="showPrimaryIns">
  <input type="hidden" name="primaryContract" value="" id="showPrimaryContract">
  <input type="hidden" name="primaryGroup" value="" id="showPrimaryGroup">
  <input type="hidden" name="secondaryInsName" value="" id="showSecondaryIns">
  <input type="hidden" name="secondaryContract" value="" id="showSecondaryContract">
  <input type="hidden" name="secondaryGroup" value="" id="showSecondaryGroup">
  <input type="hidden" name="cardType" value="" id="cardType_id">
  <input type="hidden" name="ccCardSurChrgAmt" value="" id="ccCardSurChrgAmt">
  <input type="hidden" name="paymentTypeFlag" value="" id="paymentTypeFlag">
  <div class="row align-items-center">
    <div class="col">
      <div class="form-group mb-4">
        <label for="" class="text-dark fw-600">Patient Date of Birth <span class="text-danger">*</span></label>
        <div class="input-group input-group-alternative">
          <div class="input-group-prepend">
            <span class="input-group-text"><i class="ni ni-calendar-grid-58"></i></span>
          </div>
          <input type="text" name="invoiceDetails.dob" maxlength="10" size="12" value="" onblur="javascript: dobOnBlur(this)"
            onfocus="this.style.background='#A4CEEC none repeat scroll 0 0';this.style.color='#000000';if(this.value==this.defaultValue)this.value=''" class="disabledstyle form-control datepicker" id="dob" placeholder="MM/DD/YYYY">
        </div>
      </div>
    </div>
    <div class="col px-0" style="max-width: 40px">
      <h6 class="form-group mb-0 text-center text-warning">
        <small class="fw-600">OR</small>
      </h6>
    </div>
    <div class="col">
      <div class="form-group mb-4">
        <label for="" class="text-dark fw-600">Last 4 Digits of SSN <span class="text-danger">*</span></label>
        <div class="input-group input-group-alternative">
          <div class="input-group-prepend">
            <span class="input-group-text"><i class="ni ni-credit-card"></i></span>
          </div>
          <input type="text" name="invoiceDetails.ssnNumber" maxlength="4" size="4" value="" onkeypress="return numbersonly(this, event);" class="form-control" id="ssnNumber">
        </div>
      </div>
    </div>
  </div>
  <div class="form-group">
    <label for="" class="text-dark fw-600">Account Number <span class="text-danger">*</span></label>
    <div class="input-group input-group-alternative">
      <div class="input-group-prepend">
        <span class="input-group-text"><i class="ni ni-badge"></i></span>
      </div>
      <input type="text" name="invoiceDetails.invoiceNumber" maxlength="8" size="10" value="95244590" onkeypress="return numbersonly(this, event);" class="blurstyle form-control" id="invoiceNumber">
    </div>
    <div class="text-right">
      <a href="#!" data-toggle="modal" data-target="#accountModal" class="mt-2 text-warning d-inline-block"><small class="fw-600">Click here to locate Account Number</small></a>
    </div>
  </div>
  <div class="text-center">
    <a href="#" onclick="getInvoicetotalAmount(this,document.getElementById('invoiceNumber'),document.getElementById('ssnNumber'),document.getElementById('dob'));javascript:resetInsInfo(this)" ;="" type="button" id="viewBill" class="btn btn-default mt-4">
                      View Bill
                    </a>
  </div>
</form>

Text Content

WELCOME TO ANESTHESIA BUSINESS CONSULTANTS
ONLINE BILL PAYMENT PORTAL

PAYMENT INFORMATION

Patient Date of Birth *


OR

Last 4 Digits of SSN *

Account Number *

Click here to locate Account Number
View Bill

ACCESS YOUR ACCOUNT SECURELY

ABC offers the following bill payment options:

 * Securely make your payment online.
 * To make a credit card payment using our automated system, please call the
   number located on your statement.
 * To set up a payment arrangement, please call the number located on your
   statement.

 * Review your statement for the name of the provider/practice your check should
   be made out to.

For questions, email us at customer.service@coronishealth.com




FAQS


WHAT OPTIONS ARE AVAILABLE FOR ME TO PAY MY BILL?

ABC offers the following bill payment options:

 * Securely make your payment online.

 * To make a credit card payment using our automated system, please call the
   number located on your statement.

 * To set up a payment arrangement, please call the number located on your
   statement.

 * Review your statement for the name of the provider/practice your check should
   be made out to.


MY EXPLANATION OF BENEFITS STATES THAT I AM NOT RESPONSIBLE FOR THE TRANSFER
AMOUNT SHOWING ON MY BILL SO WHY AM I BEING BILLED THIS ADDITIONAL AMOUNT?

It could be an issue where we are not contracted with your insurance company,
but the only way to be clear is for us to review your EOB.


I GAVE MY INSURANCE INFORMATION AT THE TIME OF SERVICE, SO WHY AM I STILL
GETTING BILLS REQUESTING INSURANCE INFORMATION?

It can take up to 30 days for your payment to post to your account. If you
provide us the check number, check date, payment amount and date it cleared your
bank we can trace your payment to ensure it posts to your account.


I TRIED USING YOUR AUTOMATED PHONE SYSTEM BUT IT DIDN'T WORK FOR ME. WHY?

Account numbers are 8 digits long and can be located in the yellow box on the
top right-hand side of your statement. Account numbers begin with a 1 or a 3 and
are 8 digits long. This number is located in the yellow box on the top
right-hand side of your statement. All other account/invoice numbers require
agent assistance.


WHY DID MY INSURANCE NOT PAY MORE ON THE CLAIM?

That is something that you would have to discuss with your insurance company. We
are billing what the insurance company has advised based on your insurance
policy.


WHY AM I BEING BILLED FOR TWO ANESTHESIA PROVIDERS WHEN I ONLY HAD ONE IN THE
ROOM WITH ME?

You had what is called "Team Anesthesia" one provider was the anesthesiologist
the other was a Certified Registered Nurse Anesthetist (CRNA). Both the
anesthesiologist and CRNA shared in caring for the patient, allowing both to
bill for their services.


WHY IS MY INSURANCE PARTICIPATING WITH THE FACILITY BUT NOT WITH THE
ANESTHESIOLOGIST?

Anesthesia Groups bill separately from the facility. You may file an appeal with
your insurance carrier for additional payments on your account and in some
cases, we may file the appeal on your behalf.


WHY DID IT TAKE SO LONG FOR ME TO RECEIVE A BILL AFTER MY PROCEDURE?

We do not bill the anesthesia patient until the claim has been fully processed
by your insurance company.


SUPPORT

CONTACT OUR SUPPORT TEAM

customer.service@coronishealth.com

CALL OUR SUPPORT TEAM

1-800-222-1442

© 2022 Anesthesia Business Consultants, LLC
© 2022 Medac
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