Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment plan policy. You will be asked to sign a copy of this policy but will have this copy as a reference.
1. INSURANCE. We participate in most insurance plans, including Medicare. If you are not insured by a plan we do business with, payment is expected in full 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. It is your responsibility to obtain any referrals or prior authorizations. Please contact your insurance company with any questions you may have regarding your coverage.
2. CO-PAYMENTS AND DEDUCTIBLES. All co-payments and deductibles 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. If you do not have your copayment at the time of service, you will be rescheduled.
3. NON-COVERED SERVICES. Please be aware that some- and perhaps all- of the services you receive may be non-covered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services in full at the time of the 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 card to provide proof of insurance.
5. CLAIMS SUBMISSION. We will submit your claims and assist you in any way we reasonably can to help you 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 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 visit so we can make the changes in our billing system. If your insurance does not pay your claim in 45 days, the balance will automatically be billed to you.
7. NONPAYMENT. If your account reaches 90 days past due, you will be referred to a collection agency if you do not contact the office to make arrangements. If your account is referred to a third-party collection agency, you will be responsible for any collection fees, interest and other expenses necessary to collect on your account, including court costs, should legal action be taken. You and your immediate family members may also be discharged from the practice for nonpayment. You will receive a letter in the mail that you have 30 days to find another doctor. During those 30 days, our doctors will be able to provide emergency care only.
Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for the area.
Thank you for understanding our payment policy. Please let us know if you have questions or concerns.