Mid-Atlantic Stone Center /
     Atlantic Lithotripsy
"Leaders in Lithotripsy"


picture
 
  NEWS
 
 
 
 

Mid-Atlantic Stone Center /
  Atlantic Lithotripsy

100 Brick Road; Suite 103
Marlton, NJ 08053

Phone: 856.983.7337
Fax: 856.983.6970


Notice of Privacy Practices

Mid-Atlantic Stone Center ("Center") is pleased to provide you with the following information, in accordance with the New Jersey Out of Network Consumer Protection, Transparency, Cost Containment and Accountability Act, with regard to Extracorporeal Shockwave Lithotripsy ("ESWL") treatment at the Center. The Center only provides services to patients whose physician has scheduled them for ESWL at the Center or at Virtua Health.

  1. All Center services for patients who are insured under Medicare, Medicaid, Tri-Care or other direct government insurance plans are provided under arrangement with Virtua Health, 90 Brick Rd., Marlton, NJ 08053. Patients insured under direct government insurance plans should contact Virtua Health and/or their plan contact for information related to charges with regard to ESWL treatment provided at the Center under arrangement with Virtua Health.

  2. The Center is a participating "in network" provider in the following health plans and bills those plans globally. For all of the participating "in network" plans set forth below in this section 2, the charges (available at the Center and upon request) billed globally by the Center include all charges for physician services, technical lithotripsy services and related items, facility fees, and anesthesia services for patients who receive ESWL treatment at the Center. The patient is responsible for, and will not be charged in excess of, all co-payment, deductible and co-insurance charges in accordance with the terms of the "in network" plans set forth below in this section 2.

    • Aetna, Aetna Medicare, Aetna Meritain, AmeriHealth Administrators, AmeriHealth HMO, AmeriHealth Personal Choice, AmeriHealth POS, AmeriHealth 65, Cigna, Horizon, Horizon Federal, Horizon HMO, Horizon NJ Health, Horizon POS, Horizon PPO, Independence Administrators, Independence Personal Choice, Keystone, Keystone 65, Magnacare, Oxford, Qualcare HMO, Qualcare PPO, US Family Healthplan


  3. The Center is a participating "in network" provider in the following health plans for patients who receive ESWL treatment at the Center but does not bill those plans globally:

            United Healthcare, United Healthcare UMR and United Healthcare Community Plan

    For United Healthcare and United Healthcare UMR:
    • the Center charges (available at the Center and upon request) cover only the Center's technical lithotripsy services, facility fees, anesthesia services and related items for ESWL treatment at the Center and for the technical lithotripsy services, anesthesia services and related items only, the patient is responsible for, and will not be charged in excess of, all co-payment, deductible and co-insurance charges in accordance with the terms of the applicable plan.
    • the Center charges do not include charges for physician services or related items. The physicians who provide professional ESWL services at the Center may or may not participate in United Healthcare and/or United Healthcare UMR. Patients should contact (see contact information below) the physician arranging for the Center services to determine if they participate in United Healthcare and/or United Healthcare UMR.
    • patients covered by United Healthcare or United Healthcare UMR: (i) should contact their health plan carrier for further consultation on the total charges for all of the services provided by the Center and the physician with regard to ESWL treatment at the Center; and (ii) are responsible for all co-payment, deductible and co-insurance charges in accordance with the terms of the United Healthcare and/or United Healthcare UMR plans.


    For United Healthcare Community Plan:
    • the Center charges (available at the Center and upon request) cover only the Center's technical lithotripsy services and related items and facility fees for ESWL treatment at the Center and for the technical lithotripsy services only, the patient is responsible for, and will not be charged in excess of, all co-payment, deductible and co-insurance charges in accordance with the terms of the applicable plan.
    • the Center charges do not include charges for physician services, anesthesia services or related items. The physicians who provide professional ESWL services at the Center and the anesthesiologists who provide anesthesia at the Center may or may not participate in United Healthcare Community Plan. Patients should contact (see contact information below) the physician arranging for the Center services and Rancocas Anesthesiology, PA ("Rancocas"), to determine if they participate in United Healthcare Community Plan.
    • patients covered by United Healthcare Community Plan: (i) should contact their health plan carrier for further consultation on the total charges for all of the services provided by the Center, the physician and Rancocas with regard to ESWL treatment at the Center; and (ii) are responsible for all co-payment, deductible and co-insurance charges in accordance with the terms of the United Healthcare Community Plan.


  4. The Center is not an "in network" provider for any health plans other than as set forth in 2 and 3 above (including self-funded health benefit plans). Patients should contact their health plan carrier for further consultation on the total charges for all of the facility and technical services provided by the Center, the physician and Rancocas with regard to ESWL treatment at the Center for all plans that are "out of network" (meaning all health plans that are not direct government plans billed by Virtua, described in 1 above, or plans identified in 2 or 3 above as "in network"). Patients may have a financial responsibility for "out of network" health plans in excess of the patient's copayment, deductible or coinsurance and the patient may be responsible for any charges in excess of those allowed by their health plan.

All anesthesiology services at the Center are provided by:

  • Rancocas Anesthesia, PA
  • 15000 Midlantic Drive
  • Suite 102
  • Mt Laurel, NJ 08054
  • 856-829-9345

Please see the Physician Member tab on the Center's website at http://www.midatlanticstonecenter.com for the name, mailing address and telephone numbers of the physicians who provide professional ESWL services at the Center.

All radiology services at the Center are provided by the Center.


Click Here for a PDF version of this document.


{Story 1 Title}

{Story 1}
{Story 2 Title}

{Story 2}