Payment Policy (Non-Concierge)
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. Please read it and ask us any questions you may have. A copy will be provided to you during your appointment and we ask you sign in the space provided demonstrating you have understand and have read it through.
Insurance
We participate in most insurance plans, including Medicare. If you are not insured by a plan we are in network with, payment in full is expected at each visit. If you are insured by a plan we are in network with but do not 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 & Deductibles
All copayments 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 copayments and deductibles from patients for claims submitted can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.
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 visit.
Proof Of Insurance
All patients must complete our patient demographics/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 may be responsible for the balance of a claim.
Card on File
All patients that are patients of the practice must agree to have a credit card on file with the practice at all times. The purpose of the card on file is to ensure we are reimbursed for the services rendered to you, collect account balances and collect no show fees. If you do not wish to provide a credit card on file and sign the agreement or decide to remove the card on file, we reserve the right to discharge you from the practice and you will not be able to obtain future appointments unless you place a card on file with the practice.
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.
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.
Non-Payment
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 email 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.
Missed Appointments (Regular)
Our policy is to charge you $75 for missed or canceled appointments if they are not cancelled within 24 hours of the request. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment.
Missed Appointment (Diagnostic Ultrasound)
Our policy is to charge for missed diagnostic Ultrasound/ECHO appointments that are cancelled within 48 hours of the date of your confirmed appointment time. The charge of $80 will incur and be directly billed to you. If you call ahead of time and cancel your appointment/reschedule we do not charge you a fee. These fees are used to pay our mobile ultrasound technician.
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.
