Thank you for choosing our practice! We are committed to the success of your medical treatment and care and we strive to keep your costs reasonable as well as manageable. Please understand that payment is part of this treatment and care.
For your convenience, we accept several forms of payment, including the following:
We participate in most major insurance plans. Since these contracts frequently change, we may ask you to contact your insurance company to verify our participation in your plan. Our staff will verify your insurance status and may ask for your card(s) at each visit. Some insurance plans have co-payments and this will be collected at the time of service. If insurance verification cannot be established during your visit, full payment will be expected at that time until the matter can be resolved.
Our office manager and/or insurance coordinator can assist you further should you have additional questions.
We currently contract with Medicare, BCBS, TriCare, MailHandlers, Workmans Compensation, and Medicaid just to name a few.
If you are not sure about your coverage, please contact your insurance provider to verify that we are in network with your plan.
If you have an HMO or other managed care plan, you need a referral authorization from your primary care physician. This is also necessary for out-of-state plans. If we have not received an authorization prior to your arrival at the office, your appointment will have to be rescheduled.
Your financial responsibility depends on a variety of factors, explained below.
|If you have...||You are responsible for...||Our staff will...|
Also known as indemnity, regular insurance or insurance. 80% / 20%.
|Payment is the patient's responsibility for all office visits, office procedures, and other charges at the time of the office visit.||Call your insurance company ahead of time to determine deductible and co-insurance.|
|HMO & PPO Plans which we have a contract.||If the services are covered by the plan:
All applicable co-pays and deductibles are requested at the time of the office visit.
If the services are not covered by the plan:
Payment in full is requested at the time of visit.
|Call your insurance company ahead of time to determine co-pays, deductibles, and non-covered services for you.
File an insurance claim on your behalf.
|HMO with which we are not contracted.||Payment in full for office visits, office procedures, and other charges at the time of the visit.||Provide the necessary information for you to complete and file your claim directly with the insurance company.|
|Point of Service Plan or Out of Network PPO.||Payment of the patient responsibility -deductible, co-pays, non-covered services- at the time of the visit.||Call your insurance company ahead of time to determine out of network benefits, copays, deductibles covered and non-services.
File an insurance claim on your behalf.
|Medicare||If you have Regular Medicare, and have not met your $130 deductible, we ask that it be paid at the time of service.
Any service not covered by Medicare are requested at the time of the visit. If you have Regular Medicare as primary, and also have secondary insurance or Medigap: No payment is necessary at the time of visit.
If you have Regular Medicare as primary, but no secondary insurance: Payment of your 20% co-pay is requested at the time of the visit.
|File the claim on your behalf, as well as any claims to your secondary insurance.|
|Medicaid||We accept Medicaid only as primary, but not as a secondary insurance. Any co-pay required by your medicaid option is due at the time of the visit.||We will file the claim on your behalf.|
|Worker's Compensation||If we have verified the claim with your carrier: No payment is necessary at the time of visit.
If we are not able to verify your claim: Payment in full is requested at the time of the visit.
|Call your carrier ahead of time to verify the accident date, claim number, primary care physician, employer information, and referral procedures.|
|No Insurance||Payment in full at the time of the visit.||Work with you to settle your account. Please ask to speak with our Office Manager or Insurance Coordinator if you need assistance.|
|Cosmetic Patients||Patient is solely responsible for payment which is due in full at the time of your appointment.||Provide you with an estimated cost of the procedure before your visit.|
A parent or legal guardian must accompany patients who are minors on the patient’s first visit. This accompanying adult is responsible for payment of the account, according to the policy outlined on the previous pages. A minor is considered anyone under the age of 18.
Due to the amount of time allotted for scheduled office visits, we do request at least 48 hours notice for cancellation of any appointment. If you are scheduled for an office visit, our staff will attempt to contact you as a friendly reminder one business day before your appointment. Please help us serve you better by keeping scheduled appointments.Please let us know if you have questions or concerns.
If you have any further questions please feel free to contact our office at (843) 522-1420.