Surgery Without the Surprise Bill: A Q&A with Erica Dumont of Green Mountain Surgery Center
We sat down with Green Mountain Surgery Center's Erica Dumont to talk about what makes a surgery center different, what patients pay, and what she wishes more people understood about their insurance.
Green Mountain Surgery Center, located in Colchester, is the first multi-specialty ambulatory surgery center in Vermont, offering patients personalized service and access to convenient, high-quality, and affordable outpatient surgeries. It was recently named to Newsweek’s list of America’s Best Ambulatory Surgery Centers for the third consecutive year. Erica Dumont is the center’s Business Office and Billing Manager. We sat down with her to talk about what makes a surgery center different, what patients pay, and what she wishes more people understood about their insurance.
What is Green Mountain Surgery Center, and who is it for?
We are a multi-specialty surgery center, and we’re here to support high quality, affordable healthcare to Vermonters. We partner with area Providers to help with timely access to outpatient surgery needs. Our weekly leadership meetings are centered around patient care, what we can do better, and how we can make it more affordable, and our three Ps are what we follow: professionalism, partnership, and positivity. By the time people come here, they are really impressed with the process.
Why are your prices so much lower than a hospital’s?
Unlike a hospital, we bill a bundled rate. A hospital can charge you for every aspirin you take and every bandage you use, whereas we are billing one charge for the whole procedure, supplies included, which helps us be cost-conscious. For a common procedure like a colonoscopy, our facility fee is a fraction of what the hospital’s price transparency tool shows for the same procedure.
What does the billing process look like before surgery?
We have a robust process - we verify your insurance, provide an estimate, and call you to discuss your deductible and your coinsurance balance. We provide an estimate for the surgeon’s fee, so you have an idea of your financial expectation before coming in. You know what it’s going to cost you up front, and how much your insurance is going to cover.
What about patients without insurance?
We charge uninsured patients the same as we would an insured patient, and we offer a free and discounted care program. Unlike at a hospital, the application comes straight through my billing team, so I can look at it while the patient is on the phone and tell them immediately whether they’re approved.
What do patients misunderstand most about their bills?
A lot of people don’t understand their insurance benefits. They think that if insurance says a procedure is covered, there’s nothing to pay, and they don’t realize they have a deductible and coinsurance. We put an anatomy of an estimate on our website so patients can understand all of that, and we have a lot of conversations with them. When I can get on the phone with somebody who is upset over a bill, explain how their insurance works, and empathize with them, they really appreciate it.
What is your advice to patients?
If you understand your benefits, how they work, and what’s covered, you can advocate for yourself. Even just understanding that you have a deductible to meet helps you plan your healthcare needs for the year.
What’s coming next for the center?
A new anesthesia group is being created that will fall under the Green Mountain Surgery Center umbrella. One of the biggest things we run into is people calling us about their anesthesia bill, so bringing it in-house means patients will have one point of contact for the center and anesthesia, and it will be a lot clearer for them. It also means we will be able to offer our free and discounted care program for anesthesia, which we cannot do today.
