CLAYMAN THYROID CENTER ADVANCE BENEFICIARY NOTICE

And Notification of Research Policies

This page outlines the billing policy of the Clayman Thyroid Center. All patients are required to acknowledge their understanding of this policy prior to undergoing consultation with us.

Insurance Billing: The billing staff of the Clayman Thyroid Cancer Center will submit all surgeon charges for your operation to your insurance company for you (specifically, this is the fee for the surgeon and the assistant surgeon for performing the actual operation). The cost of your operation that is covered by your insurance will be known prior to your operation, as will the amount (if any) of your co-pay, and any deductible that you still owe on your insurance for this year. We are preferred providers for most major health plans, including Medicare, BC/BS, Humana, Aetna, Cigna, United Health Care and others. Each of these insurances cover the cost of the operation (the amount covered depends on your plan, your deductibles, and other plan-specific issues, but all cover thyroid surgery). Occasionally, there will be a remaining balance not covered by your insurance that will be your responsibility. By signing this form, you acknowledge and understand that you are responsible for any and all remaining balances that your insurance carrier indicates is patient responsibility for services rendered by Dr. Gary Clayman.

PLEASE NOTE: Do not confuse collecting operation fees from your insurance company for the surgeon's operation fee with collecting consultation fees directly from you. Consultation fees are the patient's responsibility and cannot be submitted to the insurance company. This is detailed further below. The consultation occurs days or weeks prior to you coming to Tampa for your operation, and this is not billable to any insurance company.

Payment of Co-Pay and Deductibles: It is the policy of the Clayman Thyroid Center to collect your co-pay and any deductible still owed AT THE TIME OF SERVICE. We will contact you to let you know your payment requirements and to help you make arrangements for payment prior to the day of your operation. Our billing staff will tell you the amount that is your responsibility prior to you coming to the hospital. If there are any questions regarding payment and the need to establish a payment plan, please email Nicole (Click Here) to discuss (or call her at (813) 940-3130). Our policy (like almost all doctors') is that the patient is responsible for any outstanding payments not made by their insurance company. In almost all cases, this will be known before the operation.

Payment of Consultation Fees for Services Received Prior to Traveling to Tampa

If you are able to come to Tampa for your in-person evaluation by our expert team prior to scheduling your operation, there is no cost to you other than your insurance deductibles, co-pays, and other costs that are typical for seeing any surgeon or specialist. There is no hidden or additional costs to be seen by our experts in Tampa. If you need thyroid surgery, we will know your costs prior to any operation being performed. Thyroid surgery is covered by all medical insurance provided there is an indication for surgery. We are in network for most major health plans.

Online Second Opinion Consult. For patients living a long way from Tampa, Florida, we offer a program that allows them to consult with our thyroid experts via an Online Second Opinion Consult from the comfort of their own home. This is for patients who either cannot travel to Tampa for an in-person consultation prior to scheduling their operation, or those who chose to have the online consultation rather than travel to Tampa several times. The online consultation begins first with a comprehensive telephone and online consultation. That consultation may be followed by further discussions following review of diagnostic imaging studies, laboratory studies as well as pathology. Of course, every patient is different and their consultation and needs can be quite different as well. Most insurers we are in-network with cover in-person, face-to-face services only and thus they will pay for your in-person evaluation and consultation here in Tampa. However, since the Online Second Opinion Consultation is not a covered benefit for any health plan we are aware of, the patient will be required to pay for this consultation. Thus, if you cannot travel to Tampa for an in-person evaluation before you plan your operation, you can still be evaluated and receive the expert advice of our surgeons via an online consultation, but this service is not covered by insurance and you will be responsible for this $1,500 fee.

We have developed a very smooth process to bring patients from all over the world to Tampa for their thyroid surgery. YOU MUST UNDERSTAND..... YOUR INSURANCE COMPANY IS NOT REQUIRED TO PAY A CONSULTATION FEE AND THEY WILL NOT. BY FILLING OUT THE FORMS ONLINE AND FORWARDING YOUR INFORMATION TO US TO ASSIMILATE INTO A CHART, AND HAVING THAT CHART UNDERGO A REVIEW BY DR CLAYMAN MEANS THAT YOU HAVE ENTERED INTO A CONTRACT WITH US AND THAT YOU (NOT YOUR INSURANCE COMPANY) ARE 100% RESPONSIBLE FOR THIS CONSULTATION FEE. You cannot ask your insurance company or Medicare to pay this fee. They will not.

The consultation fee is for the consultation to determine the extent of your thyroid disease and what our opinions are regarding surgery or no surgery. The consultation fee will be due even if we determine that you do not need surgery, or that surgery is not in your best interest, however, it is our policy that ONE HALF of the consultation fee is returned to you if we determine that an operation is not necessary or not in your best interest. This is not a surgery fee, this is a consultation fee and if you ask for our opinions about your thyroid disease and you go through the steps that lead to the preparation of a thyroid-specific medical record for you and a review of your records by Dr Clayman and ending with a phone consultation with him as well, then this fee is due. The fee is not dependent upon you having thyroid surgery with us. We will work with your insurance company to collect as much from them as possible for the cost of the operation, decreasing the financial burden to you as much as possible. However, the online consultation fee is NOT paid by insurance companies and will be your responsibility. Of course this fee covers all those items covered in the paragraph above regarding Florida patients, so you must read the section above for details.

By acknowledging this form (by checking the box on the Insurance Information Page of this Website) patients understand that this Consultation Fee is considered a non-covered service by their insurance company and/or Medicare. By submitting your records for review you agree to be financially responsible for payment of this chart review and phone consultation charge. Remember, you are not just paying for the phone call, you are paying for the expertise and interpretation of your entire chart by the world's most experienced thyroid team. You are also paying for the extra time and effort it takes for our staff to work with out of area and out of network insurance companies. Also realize that this method almost always allows you to avoid an extra day (or two) in Tampa since you will be able to come the morning of the operation instead of a day or two prior to the operation. Thus this policy saves you travel expenses, hotel bills, office visit fees, and time away from home. It also speeds up the time it takes to get your problem cured by about 1 month.

Appeals: All patients have the right to appeal any decision that is made by their insurance / Medicare carrier about any payments or refusal of services. This is federal law.

Questions Regarding Your Bill:  Questions should be addressed to Nicole via email or via phone at (813) 940-3130. Please do not call her or email her unless you have ALREADY had your phone consultation with one of the doctors.

Ongoing Research

The physicians at the Clayman Thyroid Center are constantly engaged with ongoing research into many aspects of thyroid disease. By becoming a patient you acknowledge that your medical records will likely be included with hundreds or thousands of other patients with thyroid disease and that specific aspects of your case will likely be examined. The purpose of this research is to allow for a better understanding of thyroid disease, how it is diagnosed, and how best it can be treated. Your information will be studied only in the collective, along with many other patients. Specific studies of you as an individual will not be undertaken. No outside information will be requested as a part of these studies.

Your information will remain private and confidential at all times. You information will not be identifiable, and at no time will your information be examined as an individual, or in any way that would allow you to be identified. Your privacy is paramount and under no circumstances will be jeopardized.

You have the right to have your medical information omitted from any research project, and this is done simply by email directly to Dr Clayman.

Clayman Thyroid Center
5959 Webb Road
Tampa
FL 33615

This page was last updated: 01/08/2024