Fees
and Insurance
Charges
for office visits are determined by the complexity of your
problem and the level of service provided. Our fees are
comparable to those of other medical providers in the
community. We encourage you to discuss our fees with us
should questions arise.
The following is our Financial Policy, which we ask that
you review and become familiar with. In order to control
costs and provide our patients with quality medical care, your
cooperation is necessary.
Insurance
We are participants in many
insurance companies. Please call our
office or your member services representative at your insurance
company to find out if we are on your list of
providers.
If your insurance company requires you to have a referral from
your primary care physician in order to be treated by our
doctors, please verify that this process has taken place.
If a referral is not in place, you can not be seen until one is
received.
Insurance forms for services rendered (non-optical services) will be completed and
filed by our office. Please be sure to supply our staff
with accurate insurance information and a copy of your insurance
card.
Co-Pays
must be paid at the time services are rendered, as required by
your insurance company. We accept cash, check Visa and
Mastercard. You are responsible for knowing if you have a
co-pay. A $5 billing charge will be added to all
co-pays not made the day you are treated. Also, there will
be a $20 fee for all returned checks.
If you do not have insurance, payment in full is expected at the
time of service unless you have made prior arrangements with our
billing department.
You will only receive a statement from this office when the owed
amount is your responsibility. Please pay your bills
promptly. A service charge of 1% will be assessed on all
balances over 90 days past due. If you feel that your insurance carrier has not
paid correctly, contact them instead of our billing
office. We will not be able to provide you with any
specific information regarding your particular insurance
policy.
We are committed to providing the best treatment for our
patients, and our charges are within the ranges of what is usual
and customary for this area. However, many insurance
carriers will have their own interpretation of what this means.
Medicare
For our patients who are eligible for Medicare, we are
"Participating Physicians". This means that we
must accept Medicare's allowed charge for the services rendered,
writing off the difference between what we charge and Medicare
approves. Medicare will send a check directly to our
office for 80% of the approved amount. The patient is
responsible for 20% of the approved charge, plus any
deductible. If you have a secondary insurance, we will
submit a claim to them for any remaining balance after Medicare
has paid. Please remember, that although we will accept
assignments for Medicare patients, the beneficiary, as
required by federal law, is responsible for 20% of the
approved amount and also for any routine services not covered by
Medicare.
Work
Related Injuries
We are
happy to provide treatment for work related injuries.
However, all charges incurred are ultimately the responsibility
of the patient. You must supply us with your date of
injury, allowed diagnoses and your claim number along with your
employers MCO (Manages Care Organization). Payment
from the patient is expected, unless we receive the necessary
information to submit a claim for services rendered.
In case of divorce, the parent seeking treatment is ultimately
responsible for payment of the bill unless we receive legal
documentation stating otherwise.
Accounts that are 90 days past due, could be subject to
collection action. Any legal action would cause a
breach in the physician/patient relationship, which may result
in discharge fro the practice.
The above financial policy will allow
us to provide quality care to our valued patients. If you
have any questions, or need clarification of the policies listed
above, do not hesitate to contact our billing office at (419)
578-7527.
