Financial Policies

Financial Policies

Thank you for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care. Your clear understanding of our financial policies is important to our professional relationship. Please ask if you have any questions regarding our policies.  It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, etc).

 Insurance

We participate in many insurance plans. You can check our website for a list of plans that we are in network with. It is your responsibility to verify with your insurance company if we are in-network with your particular plan.  If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

Co-payments and deductibles

All co-payments, deductibles and/or co-insurance must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.  We accept cash, check, Visa, Mastercard, Discover, and American Express.

Non-covered services

Please be aware that some – and perhaps all – of the services you receive may be not covered or not considered reasonable or necessary by insurers. You must pay for these services in full at the time of visit.

Proof of insurance/Coverage Changes

All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.  If you fail to provide us with the correct insurance information in a timely manner, you will be responsible for the balance of a claim.

 Claims submission

Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

We will submit your claims to your primary insurance carrier if we participate with your plan. We do not submit claims to a secondary or tertiary carrier.  If you have insurance that we do not participate with, then we can provide you with a claim form that you can submit to your plan for out of network reimbursement if you have those benefits.  Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you. Please be aware that the balance is your responsibility whether or not your insurance company pays your claim.

Nonpayment

If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.

Returned Checks

The charge for a returned check is $10 payable by cash or credit card. This fee will be applied to your account in addition to the insufficient funds amount.

Workers’ Compensation

Our office does not perform any visits related to any injury sustained at work. We will not complete any paperwork or submit claims for Workers’ Compensation.  You should contact your Human Resource Department to find out where they would like you to seek treatment.

Motor Vehicle Accident and Third Party Billing

We do not do any third party billing. Our relationship is with you and not with the third party liability insurance (auto, homeowner, etc.)  It is your responsibility to seek reimbursement from them.  However, at your request, we will submit a claim to your primary health insurance carrier.  You may receive an accident questionnaire from them to be completed by you.  If the questionnaire is not returned to your medical insurance company and/or we receive a denial on your claim, you will be responsible for payment in full.

 

Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area. Thank you for understanding our financial policies. Please let us know if you have any questions or concerns.