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Financial Policies

ABOUT YOUR BILL

INTRODUCTION

We are committed to providing quality healthcare and services to all patients.  This brochure is meant to assist you with any questions you might have about our accounting and billing systems.

As a courtesy to patients and their families, our Business Office will submit Physician claims to any insurance company on behalf of the patient.  To speed up the claims process, it is important that complete and accurate insurance information be given when the patient is seen.

You may receive monthly statements while your claim is being processed depending on the arrangement we have made with your insurance company.  We appreciated any assistance you can give in helping your insurance company during the claims process.  An itemized bill will be sent to you only on request.

PATIENT RESPONSIBILITY

All co-pays, deductibles, and co-insurance are due at the time services are rendered.  You are responsible for all charges incurred.  We will file your insurance for you.  Your insurance company will notify you and us of their determination.  If you disagree with your insurance companies determination, you must notify them immediately.  The balance of your account is your responsibility regardless of your insurance company's determination to pay.  Your insurance policy is a contract between you and your insurance company.  If your insurance company has not paid your account in full within 30 days from the date services are rendered, the balance will  automatically be transferred to your responsibility.  Any balances not paid in full within 90 days from the date of services are rendered will be turned to collections.  Please be aware that some, and perhaps all, of the services provided by the physician, an audiologist, or other licensed professionals may be considered non-covered services or unreasonable and unnecessary under your medical insurance.  It is your responsibility to provide us with your accurate insurance and primary care provider information.

More and more insurance companies are requiring authorization or pre-certification before patients receive any medical services.  If your insurance company requires this it is your responsibility to obtain this before being seen by us.   Usually you &/or the policy holder can get the authorization needed for treatment.    If authorization or pre-certification is not received and is considered necessary by your insurance company, they may deny your claim in part, or in full.  The balance will be your responsibility.

PAYMENT RESPONSIBILITY

An expected insurance payment to us does not replace the patient's obligation to pay any outstanding balance.  We reserve the right to expect payment directly from the patient or the responsible party in certain situations or if insurance payment is particularly slow.  Financial responsibility for children's services is that of the parent who brings  the child for care.

COLLECTIONS

So that our staff may use their time providing patient care, any balances not paid within 90 days from the date services were rendered will be turned to collections .

MEDICARE

We are certified Medicare providers and will send your bill directly to Medicare for payment.  If you have insurance secondary to Medicare, our Business Office will submit one supplemental insurance claim.  This supplemental claim can only be completed after we have received the Medicare payment, and can only be submitted if all additional insurance information has been provided.

While Medicare must be allowed as much time as needed to process a claim, supplemental insurances will have up to 30 days from billing before the outstanding balance is determined to be the patient's responsibility.

MEDICAID

Medicaid billings are also submitted on behalf of the patient. If it is determined the patient is not eligible or has not qualified for Medicaid, the patient will be billed for any services received.

INSURANCE

The Billing Office will bill up to two insurance companies if insurance information and assignment of benefits is given when registering.  Any balance not paid within 30 days of billing will become the patient's responsibility.

Your insurance company will notify you and us of their determination.  If you disagree with your insurance companies determination, you must notify them immediately.  The balance of your account is your responsibility regardless of your insurance company's determination to pay. 

HMOS/PPOS

If we have a contract with your insurance company, the bill will be submitted according to contractual obligations.  Any coinsurances, deductibles, or non-covered services are the patient's responsibility and if known are payable at the time of service or when the insurance determination is made but no longer than 30 days.

WORKER'S COMP, ACCIDENTS, INJURIES

 Injuries or accidents related to work, vehicle or public related  injuries will be treated as a normal insurance claim.  You will be help personally responsible for your bill.  Since each case may take many months to resolve,  we cannot wait for final resolution or decisions.  Payment arrangements should be made on these accounts to keep them from becoming past due.

WHEN A PATIENT OWES A BALANCE

We expect that patients and/or their families will make a good faith effort to pay any balance due the clinic.  The Billing Office will work with you to establish a reasonable method of settlement.

An account is considered delinquent or past due when:

· You have made no  payment arrangements within the time limits outlined above under responsibility.

· There is no response to our mailings or phone calls.

· Insufficient funds check

· A required Financial Assistance Application form is not completed.

· Established financial arrangements are not met.

If you dispute a balance, the situation will be reviewed before further collection efforts are pursued.  In cases where all reasonable efforts to collect a balance have been made, the account will be referred to an agency for follow-up and collection, or to an attorney for legal action.  The cost to collect a suit on an account will be added to the original balance owed.

We have personnel who can assist you in establishing financial arrangements.

Balance

   Minimum payment
$100 or less $25 per month
$101 to $999   $100 per month
$1000 or more    $200 per month

Long-term payment arrangements can be requested by completing a  financial assistance application.  If an unpaid balance is more than $1000, you will be asked to obtain alternative financing. If unable to qualify a payment schedule will be made measuring the established payment against the patient's spendable income (available income after reasonable monthly obligations). We honor Visa and Mastercard for the payment of any account.  Payments are accepted over the phone, in person, or by mail. If you have questions about any bill you receive from our office, please call the following number:

405 751-7682.

Thank you for your trust!