We recognize the need for definite understanding between patients and physicians regarding financial arrangements for medical care. We have established the following financial policy in response to this need. It is our hope that you will understand that these payment collection practices are a necessary part of assuring the financial resources required to provide the best medical care possible to our patients and community. We bill all insurances as a courtesy to our patients. You, the patient or responsible party, should facilitate the payment process by providing our office with current insurance information including the correct insurance responsible for payment at the time service is rendered, billing address, phone numbers, member ID numbers, employer information, and effective dates for all insurances. Please bring your insurance cards with you to each visit, and remember to notify staff at time of check in to any changes to insurances. You should also cooperate fully with our office and/or your insurance company in providing additional information as needed for reimbursement. Ultimately, the patient or responsible party is responsible for payment when insurances fail to pay clean claims, or when accurate insurance information was not provided at time of service. We will allow a reasonable amount of time for claim processing by insurance; (no longer than 90 days), once this time has passed, payment will be expected from the patient.
Copays: Your copay is determined by your contract with your insurance company. This is a requirement of your insurance company, and is due at the time of services rendered. Copays not paid at time of service will be subject to an additional $20 statement preparation and mailing fee for each statement the patient receives per 28 day billing cycle.
Deductibles & Allowed Amounts: We will also collect any deductible or allowable amount the patient is determined to be responsible for according to their insurance contract at the time of services rendered. A summary of these charges will be given for each visit and/or service which should be kept by patient for their records. Payment plans may be arranged for deductible or allowed amounts, and will NOT be subject to interest charges. These payments may be made up to a maximum of 6 months, and there will be a one-time $50 statement preparation and mailing fee added to total charges for payment plan arrangements. A contract must be signed for any payment plan arrangements, and a copy will be given to patient for their records.
Self -Pay Patients: We offer discounted fees on many services to our self-pay patients. Please inquire with staff regarding discounted rates. A down payment is required before all elective procedures. This down payment is to be at least half the fee for the anticipated service, and may increase or decrease if the actual service performed is more or less extensive than anticipated. The remaining balance is to be paid in monthly installments as arranged by contract at time of service, and not to exceed 6 months. Evaluation and management, or office visit fees are due in full at the time of service, and unpaid fees will be subject to a $20 statement preparation and mailing fee for each statement received in a 28 day billing cycle. Cosmetic procedures are required to be paid in full at time of service.
Referrals and Prior-Authorizations: If your insurance requires referral from a primary care physician (PCP), you are required to have prior authorization from your PCP and insurance company prior to your visit. If this authorization is not provided, you will be asked to reschedule your appointment or otherwise be responsible for exam fee payment. We will be happy to assist you in obtaining this authorization if we are notified prior to exam, and make an effort to determine if your insurance requires referral prior to your exam.
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