Thank you for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy.
1. Insurance. We participate in many insurance plans. 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.
2. 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.
3. 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.
4. Proof of insurance. 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 you fail to provide us with the correct insurance information in a timely manner, you will be responsible for the balance of a claim.
5. Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
6. Coverage changes. 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 your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.
7. 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.
8. Missed appointments. Our policy is to charge for missed appointments not canceled within a reasonable amount of time. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment. Any balance accumulated because of a missed appointment fee will need to be paid before scheduling another appointment.
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 payment policy. Please let us know if you have any questions or concerns.
- It is your responsibility to notify this office of any changes of information, including name change, change of address, phone numbers and insurance.
- We have a very specific protocol for insurance authorizations/referrals. If your insurance company requires a referral or pre-authorization, please ask for the protocol.
- We cannot authorize a visit to a specialist to whom we did not refer you.
- We do not do retroactive authorizations. You must follow our protocol for authorization/referral numbers. We cannot authorize a visit to a specialist while you are at that specialist’s office. Our protocol is that we have a minimum of 3 days notice before your visit to see the specialist; otherwise, the specialist’s charges will be your financial responsibility.
- Your co-payment and/or co-insurance must be paid at each visit. You will be charged an additional co-pay amount if not paid on the same date as service.
- We will file your insurance if we are contracted with your insurance company. Any balance unpaid by your insurance company, or if your balance is outstanding for thirty (30) days, will be your responsibility. You will be responsible for any disputed claims. If/when the claim is paid, you will be re-imbursed with-in thirty (30) days.
- Any disputes about coverage or benefits are your responsibility and are between you and your insurance carrier. If you have questions regarding coverage/payment, you must direct those inquiries to your insurance carrier.
- It is required by your insurance company that you HAVE YOUR INSURANCE CARD WITH YOU at every visit.
- With great effort, we try to see patients who are sick on the same day. There may be days that we cannot, therefore, it is best to call the office between 7:30 and 9:00 AM for the best chance of being seen that day.
- We recognize the usual holidays. During inclement weather, please contact the office to make sure we are open. You may also visit our website for that information. www.macfp.com. We make effort to have the office open at those times. If you have an emergency, call 911 or go to the nearest emergency room.
- We have 24 hour coverage. Call the office and the message will direct you to the physician on call after hours.
- When your prescription expires, you are required to schedule an office visit to renew your prescription. Please allow 48 hours for refills on all medications. We do not accept faxed refill requests from ANY pharmacy. It is the patients responsibility to call the office.
- We do not prescribe antibiotics over the phone. You must schedule an appointment for treatment requiring an antibiotic.
- All patients must give our office 24 hours notice for cancellation. You will receive an automated phone call two (2) days prior to all appointments. However, PLEASE do not rely on the phone call to remember your scheduled appointment.
- There will be a fifty dollar ($50.00) charge for appointments not cancelled with-in 24 hours of the scheduled appointment. THIS MUST BE PAID BEFORE SCHEDULING AN APPOINTMENT.
- If you have not been notified of any test results ordered by your provider within two (2) weeks, please call the office immediately at (919) 858-8360, extension 10.
- All appointments for lab work must be accompanied by or followed up with an office visit unless specifically stated otherwise by the provider. Results will not be provided otherwise.
- We will perform laboratory testing ordered ONLY by MFP providers.