Your understanding of our financial policies is an essential element of your care and treatment. If you have any questions, please discuss them with our front office staff or supervisor.
As our patient, you are responsible for all authorizations/referrals needed to seek treatment in this office. It is your responsibility to have a referral sent to our office for all HMO plans prior to your appointment. Failure to do so may result in you having to pay for your visit.
Unless other arrangements have been made in advance by you, or your health carrier, payment for office services are due at the time of service. You must provide our office with a photo ID and Insurance card upon check in. Failure to provide a photo ID and Insurance card will result in you having to pay for your visit. We will accept VISA, Mastercard, Discover, cash or check.
Your insurance policy is a contract between you and your insurance company. As a courtesy, we will file your insurance claim for you if you assign the benefits to the doctor. In other words, you agree to have your insurance company pay the doctor directly. If your insurance company does not pay the practice within 30 days from your date of service, we will have to look to you for payment. Claims will not be resubmitted with different codes if they have been denied due to lack of coverage.
We have made prior arrangements with certain insurers and other health plans to accept an assignment of benefits. We will bill those plans with which we have an agreement and will only require you to pay the co-pay/co-insurance/deductible at the time of service.
If you have insurance coverage with a plan with which we do not have a prior agreement, we will prepare and send the claim for you on an unassigned basis. This means your insurer will send payment directly to you. Therefore, all charges for your care and treatment are due at the time of service.
All health plans are not the same and do not cover the same services. In the event your health plan determines a service to be “not covered”, or you do not have an authorization, you will be responsible for the complete charge. We will attempt to verify benefits for some specialized services or referrals, however, you remain responsible for charges for any service rendered. Patients are encouraged to contact their plans for clarification of benefits prior to services rendered. It is your responsibility to verify coverage and benefits for all services including labs ordered, imaging and procedures performed and to know the limits and exclusions of your insurance coverage.
You must inform the office of all insurance changes and authorization/referral requirements prior to your visit. In the event the office is not informed, you will be responsible for any charges denied.
There are certain elective surgical procedures for which we require prepayment. You will be informed in advance if your procedure is one of those. In that event, payment will be due one week prior to the procedure.
Past due accounts are subject to collection proceedings. Additional billing statements will incur a $10 fee. All costs incurred including, but not limited to, collection fees, attorney fees and court fees shall be your responsibility in addition to the balance due this office.
There is a service fee of $50.00 for all returned checks. Your insurance company does not cover this fee. ALL Credit, Debit and HSA card transactions have an additional 3% fee.
There is a $75.00 fee for all no show appointments AND cancellations not done 24 hours in advance. If you choose to leave your appointment prior to seeing the Doctor this will be an automatic same day cancellation and the fee will be applied.
