We participate in many managed care programs. These insurance contracts are frequently reviewed and changed; therefore, we will ask for a copy of your ID card at each visit. Prior to your visit, please contact your health plan to verify our participation in your plan. Most plans require members to pay an office co-payment for each office visit. Payment of the co-payment will be expected at the time of your visit. If there is a problem with the verification of your insurance information, full payment for services rendered will be expected at your visit. Therefore, it is incumbent upon you to ensure that you provide the practice with your most recent and correct insurance information.
For your convenience, we have answered a variety of commonly-asked financial policy questions below. If you need further information about any of these policies, please ask to speak with one of the patient coordinators or with the Insurance Coordinator.
How may I pay?
We accept payment by cash, check, VISA, Mastercard, American Express, Discover and financing through Care Credit.
Do I need a referral?
Which plans do you contract with?
What is my financial responsibility for services?
If you have… Commercial Insurance also known as indemnity, regular insurance or insurance. 80% / 20%.
You are responsible for… Payment of the patient responsibility for all office visits, office procedures, surgery and other charges at the time of the office visit or at the pre-op visit.
Our Staff will…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, surgery 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.
If you have Regular Medicare, and have not met your $100 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.
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.
Payment in full at the time of the visit. Work with you to settle your account. Please ask to speak with our Insurance Coordinator if you need assistance.
Payment is due in full at your history, and physical appointments usually scheduled one week prior to surgery. Provide you with information for financing options through Care Credit.
If your physician recommends surgery, you will be escorted to his patient coordinator. She will answer specific questions about the cost of surgery, the surgery scheduling process, the paperwork and tests involved. If pre-certification/prior authorization is needed the Insurance Coordinator will send a letter to your insurance company.
A 10% deposit is required on all cosmetic surgeries when scheduled. The balance for these cosmetic surgeries is to be paid at the pre-operative visit one week prior to the surgery. For insurance surgeries, the co-pay and/or deductible is also required at the pre-operative visit. A cost estimate which shows your financial responsibility will be provided prior to that visit.
What if my child needs to see the physician?
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. If the minor requires surgery the same is true for the pre-operative visit. A minor is considered anyone under the age of 18.
If you have any questions please feel free to contact our office at (478) 474-2200.
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