Insurance & Billing Information for Delaney Radiology Patients

At Delaney Radiology, we’re committed to providing a better diagnostic imaging experience for patients in Wilmington, North Carolina, and surrounding areas. That includes helping you understand your insurance coverage for medical imaging services and providing you with information that will help you manage any out-of-pocket costs for your care. Please review the information below, which covers health-insurance and billing information that patients frequently ask us about.

If you have additional questions, our billing office is ready to assist you Monday through Friday from 8:00 a.m. to 5:00 p.m. Please call 910-762-3882 Opt 4 for assistance.

Your Rights and Protections Against Surprise Medical Bills

When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What Is “Balance Billing” (Sometimes Called “Surprise Billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that is not in your health plan’s network.

“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care—similar to when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services
If you have an emergency medical condition and receive emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may receive after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you receive services from an in-network hospital or ambulatory surgical center, certain providers may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections.

If you receive other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.

You are never required to give up your protections from balance billing. You also are not required to receive care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing is not allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

  • Cover emergency services without requiring you to obtain approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you have been wrongly billed, you may contact the No Surprises Help Desk at     1-800-985-3059.

Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.Visit https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_58/GS_58-3-200.html for more information about your rights under N.C. state law.

An EOB is the statement provided to the patient from an insurance company describing the action taken on a claim.

A co-payment is the amount payable by the patient as specified by their insurance policy—a sharing of costs, so to speak.

A deductible is the amount indicated in your insurance policy payable by you before benefit payments begin.

Delaney Radiology will file with any insurance company. However, to ensure that you are fully informed on the details of your coverage and costs you may be responsible for directly, we recommend contacting your insurance provider to discuss in-network coverage, deductibles and coverage details. For further coverage information, please call the customer service number on your insurance card.

Delaney Radiology participates with the following insurance companies:

  • Medicare
  • Blue Medicare
  • North Carolina Medicaid FFS
  • Medicaid Managed Care Plans: Healthy Blue, UHC, AmeriHealth, Wellcare, Carolina Complete
  • Tricare
  • Tricare Prime
  • Blue Cross of NC (all plans)
  • State Health Plan
  • Cigna (Affiliates:  GreatWest, Cigna Open Access Plus)
  • Medcost (Affiliates: American Republic, Assurant, Celtic, Guardian Life, Freedom Life, FirstCarolineCare, Mega Life, World Ins, Trustmark, Principle Life, Midwest National Life, National Foundation, Maksin Mgmt Corp, IHC Health Solutions)
  • PPO NEXT  (Affiliates: Healthstar & PHN, Beech Street, Concentra, Viant)
  • United Healthcare (Affiliates of UHC: Definity Health, MAMSI, Golden Rule, Oxford Health, PacifiCare, Midwest Security Life Insurance Company, OneNet PPO, United Medical Resources, UMR, New River Valley, All Savers)
  • BeechStreet
  • Aetna (Aetna Medicare, Coventry, Work Comp Access AWCA)
  • MultiPlan (GPA,PHCS)
  • One Call Medical
  • Coventry – includes Advantra
  • MedRisk WC
  • Employer’s Choice Network WC
  • Prime Health Services WC
  • ClaimDOC (Duplin County, Leith Automotive)
  • Humana Medicare
  • Corvel/Care IQ WC
  • Healthcare Solutions WC
  • First Medicare Direct
  • Streamline WC
  • Absolute Solutions WC
  • Navigere WC
  • Greenlink WC
  • Key Health
  • VA CCN Optum
  • LHI
  • Lucent Health

If your insurance company is not listed, we will gladly file it for you and bill you any balance due.

Unless there is a court order to establish primary coverage, the date of birth rule would apply. The parent whose date of birth comes first would be considered primary.

Yes. Please call our billing office to learn more.

Yes. Call our office to find out if we participate with the hospital that has approved you for this program.

Yes.  We contribute financially to increase the efficiency of patient care in our community and surrounding areas. The connected entities increase the efficiency of patient care and improve care management and the overall patient experience.

Delaney Radiologists Group
PO Box 63050
Charlotte, NC 28263-3050

Delaney Radiologists PA
PO Box 63032
Charlotte, NC 28263-3032

After verification of all personal and insurance information, the patient would be advised to contact their insurance company to see if the claim was properly processed.

Yes, you can pay your bill over phone using our 24/7 automated line at (910) 763-1800 option 8. We accept Visa, MasterCard, Discover, American Express, and Care Credit. You may also mail in your credit card information for payment.

We will be happy to help you set up a monthly payment plan.

We offer a discount for all self pay patients (or all patients with no insurance) if paid during the first statement period.

The hospital billed you for their part of their services including the use of their equipment (technical component) and Delaney Radiologists billed you for the radiologist’s reading of the x-ray or for performance of a procedure (professional component).

Each time a physician sees or provides a service to you, it is considered a separate occurrence, and a separate bill is generated for each occurrence.

Sites that you MIGHT get a bill from us for providing professional interpretation services include:

  • Carolina Arthritis
  • Dosher Memorial Hospital
  • Insight Imaging
  • New Hanover Health Network – including the hospital, ERs and health & diagnostic centers
  • New Hanover Medical Group
  • Novant Health Brunswick Medical Center
  • Pender Memorial Hospital
  • Urology Associates
  • Wilmington Health
  • Site Coastal Pulmonary

It is possible that we did not have your correct address. If you were a patient at the hospital, we would have received the address that the hospital has for you in their information system. That information is provided to Delaney Radiology via an electronic data transfer. If the hospital has incorrect information about you, we too will have incorrect information about you. Delaney Radiology sends two billing statements, and then a final notice to all patient accounts. In addition, multiple telephone contacts are attempted. In the case of no response, or returned mail, we have no recourse other than sending the account to collections.

A refund check will be issued to you, or we can credit your credit card account if you desire.

Refunds are issued twice a month. It usually takes about 30 days from the date that we receive the overpayment until the check is issued and mailed.

Many insurance companies do not subrogate, therefore any overpayments would be issued directly to the patient. If the insurance company subrogates, the overpayment would be issued to the insurance company.

Yes, once every twelve months.

We can bill for a screening mammogram only if you are not having any symptoms.

Medicare will pay for a bone density exam only once every two years, and only if it is a covered diagnosis.

Yes, but Medicaid is always secondary. If your primary pays as much as or more than Medicaid allows Medicaid will not make any additional payment.

You should file your auto liability insurance.