Payment is required at the time services are provided unless other arrangements have been made in advance.
We participate in many insurance plans. We recommend that you become familiar with your insurance benefits- including eligibility, covered benefits, co-insurance and deductibles. Most misunderstandings about insurance can be avoided if you understand what your policy covers. Please contact your insurance company with any questions you may have regarding your coverage. You are responsible for deductibles, co-pays, co-insurance, non-covered services, and items considered “not medically necessary” by your insurance company.
As a courtesy to our patients, our office will file claims on your behalf. Please be advised that, excluding Medicare, we do not file secondary insurance. You will be asked to present a current insurance card at every visit. If your insurance cannot be verified, payment for services is expected in full at the time of the visit. Please inform us of any changes to your address, contact information, insurance, or responsible party. Inaccurate demographic and insurance information may result in denial of your insurance claims. Your insurance may require additional information from you in order to process the claim. Failure to comply with their request within 30 days will result in full patient responsibility for the claim.
Please make sure that our physicians participate in your specific insurance plan. You can verify this by either checking your insurance plan provider directory or by calling your carrier directly.
Similarly, if we need to refer you to a specialist, please refer to your insurance plan listing of participating providers to ensure that the specialist is in your plan network prior to making an appointment.
Pursuant to our participation with your insurance plan, we are required to collect co-pays, deductibles, and co-insurance at the time of service. For minor patients, payment will be collected and is expected from the parent/ guardian present at the visit. We accept cash, checks, debit cards, Mastercard, Visa, and Discover. We accept American Express for charges greater than $50.
What is an HMO?
- An HMO (Health Maintenance Organization) is a type of health insurance that covers services within a specific network of doctors and hospitals.
- You pay a monthly or annual fee for this coverage.
How Does an HMO Work?
- You must choose a primary care physician (PCP) from the HMO network.
- Your PCP is your main doctor for all health issues.
- To see a specialist, you need a referral from your PCP.
Important Points About Referrals:
- We need to assess you before referring you to a specialist. Your symptoms must be documented in your chart for insurance to approve and cover the referral.
- It usually takes about a week to get referral approval from the HMO.
- If you want to see a specialist without our referral, your insurance will not cover it, and you’ll have to pay out-of-pocket.
- If a referral cannot be done in your preferred time, you can still see the specialist, but you will pay their full rate.
Network Limitations:
- HMOs have a smaller network of doctors compared to other plans like PPOs or POS plans.
- It’s up to you to check if a specialist is in the HMO network and accepting new patients.
Emergencies:
- For real emergencies, go to the nearest hospital emergency room.
- The terms “emergent” or “urgent” should not be used to rush referrals for office visits.
- If an expedited referral is needed (which skips our assessment), there will be an extra fee.
Outstanding patient/guarantor account balances will be e-mailed unless otherwise specified. Payment for outstanding account balances or arrangement of a payment plan is expected within 30 days of the statement billing date. Accounts more than 60 days past due will be assessed an administrative fee of $25 and forwarded to a collection agency. Should your account become delinquent, you will be responsible for any and all legal fees, court costs, and collection fees involved as a result of any collection activity.
Returned checks will incur a fee of $35. If more than one returned check is received on your account, we will require all future payments to be made by cash, cashier’s check, or credit card.
We understand that many patients have insurance plans with high deductibles or may lose coverage for a number of reasons. If, at any time, medical care becomes a financial difficulty please let us know. We are always willing to help you with payment plans or other arrangements.