FAQ Billing and Insurance

We encourage you to contact us by phone at 336-802-2000, Monday through Thursday, 8 a.m. to 5 p.m. and Friday, 8 a.m. to 3 p.m., with any questions regarding your Cornerstone bill. Experience shows that there are some questions that are more commonly asked by our patients, and we have provided the answers to these below.


Do you offer payment arrangements?

Yes, payment arrangements may be made by contacting Cornerstone Central Billing Services, Monday through Thursday 8 a.m. to 5 p.m. and Friday, 8 a.m. to 3 p.m., by calling 336-802-2000. We also accept most major credit cards.


Will you bill my primary and secondary insurance carriers?

Yes, as a courtesy to our patients, Cornerstone Health Care will submit the bill to your insurance carrier and will assist when problems arise. You are requested to supply the pertinent billing information that the insurer may require.


Is there any help available that allows me to better understand my billing statement?

Yes, our interactive tool, Understanding Your Bill, helps to explain the various sections of your bill. You may also wish to contact Cornerstone Central Billing Services at 336-802-2000, or you may e-mail us: billing@cornerstonehealthcare.com.


Are itemized statements automatically sent to patients?

Yes, you will receive an itemized statement after your visit to a Cornerstone doctor. If for any reason a copy is needed thereafter, you can contact us at 336-802-2000 and request an itemized and/or detailed billing invoice.


Is there any help available if I am experiencing a financial or medical hardship?

Yes, eligibility for financial assistance is determined by the patient's and/or guarantor's ability to pay, after all insurance and available resources have been utilized.

The program covers payment for medically necessary care, but does not cover routine co-pays and deductibles for patients having medical coverage unless a hardship can be documented. The program also excludes services deemed not medically necessary, such as cosmetic surgery, fertility services, medications, Radiopharmaceutical's, optical or orthotics.

Applicants must be prepared to apply for other social programs that are available as well. Applicants must have the necessary verification and information needed to process the application. View additional information on Financial Assistance.


Why did my insurance carrier deny the claim?

Your insurance carrier may deny the claim for one or more reasons. It is always best to call member services at your insurance carrier to discuss your account. Some typical reasons include:

  • You were not covered by your plan on the date of service.
  • The patient cannot be identified.
  • The primary physician did not issue a referral.
  • The service was not authorized.
  • The service that you received was out of network.
  • The balance is due to the patient's deductible and/or co-pay.
  • The account denied as "other insurance carrier is primary."

What is a deductible?

Deductibles are provisions that require the member to accumulate a specific amount of medical bills before any benefits are paid. Once the patient/insured has met their deductible, the insurance carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are usually annual, and generally start in January.


What is co-insurance or co-pay?

Co-insurance and/or co-pay is a form of cost sharing. After deductibles are met, the plan will begin paying a percentage of the insured's bill. The remaining amount, known as the co-insurance, is the portion due by the patient and/or insured. Managed care carriers charge co-pays for varied services.


Why did the insurance carrier only pay part of my bill?

Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services and co-pays for some services.


Why do I need to call the insurance carrier if they do not pay the bill?

You are ultimately responsible for the total bill or any portion of the bill that your insurance carrier did not pay. Cornerstone Central Billing Services will make every effort to resolve the account balance with your insurance carrier. Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance.


I belong to a managed care plan. What should I do before visiting a Cornerstone doctor?

The best patient is an informed patient. Read your insurance booklet to be sure you have followed all the guidelines for referral and authorizations, or call member services at your insurance carrier for assistance. Failure to follow your plan requirements may result in greater out-of-pocket expenses for you.


What does "in-network" and "out-of-network" mean?

If you receive your health care services from a hospital, physician or other health provider that participates in your health plan, they are considered "in-network."

Hospitals, physicians or other health care providers who do not participate in your health plan may be referred to as "out-of-network." You may have a higher co-insurance and/or co-pay for out-of-network services. In some cases, out-of-network services are denied totally.


How do I know if my health plan requires a referral or pre-certification for a service?

Your benefit booklet or provider directory should provide this information for you. If not available, call your member service unit at the insurance carrier, and they should be able to help you.


What should I do when I relocate or change my address and/or telephone number?

When your personal information changes, you should always notify us of the change by contacting Cornerstone Central Billing Services at 336-802-2000.


What should I do when my insurance carrier has changed?

When you experience any changes regarding your health insurance, you should contact all the providers that offered medical services to you.


What should I do if my health plan includes Cornerstone Health Care as a participating provider, but I receive an explanation of benefits stating I am out-of-network?

Consult your health plan's member service unit.


When is Medicare always primary, and how do you determine if Medicare is primary or secondary?

Medicare has specific guidelines to help us determine if they are the primary payer or the secondary payer. Some of the more common situations where Medicare can pay as secondary are:

  1. When the individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employment.
  2. The company has 20 or more employees or participates in a multiple-employer or multi-employer group health plan where at least one employer has 20 or more employees.
  3. The individual in question is entitled to Medicare as a result of a disability, the company has 100 or more employees, or participates in a multi-employer/multiple employer group health plan where one employer has 100 or more employees.
  4. The individual in question is Medicare entitled due to end stage renal disease. Medicare is the secondary payer to a group health plan until a 30-month coordination period has ended.