If you have insurance, a valid, verifiable insurance card must be presented at the time services are rendered. If you do not provide insurance information at the time of service you will be held financially responsible for all charges incurred. Our office does not accept retroactive Insurance.
It should be mentioned that your insurance coverage is an agreement between you and your insurance company. Unless we have a contract directly with the insurance plan, we cannot accept the responsibility of negotiating claims. We cannot guarantee the payment of your claim. If we are Out-of-Network our office does not submit claims on your behalf.
Please be aware that few insurance companies attempt to cover all medical costs. Some pay fixed allowances for each procedure while others pay only a percentage of the costs. If your insurance company pays only a portion of the bill or denies the claim, any contact or explanation should be made to you, their policyholder. Reduction or rejection of your claim by your insurance company does not necessarily relieve you of the financial obligation that you have incurred.
Non-Covered Services
You are responsible for knowing what beneifts are covered under your insurance plan. Our office can not keep track of the hundereds of different benefit plans and what is and is not covered. Most Insurance carriers ask that offices obtain an Advance Benefit Notice (ABN) for non-covered services. The requirements of these ABNs are such that our office could not comply until after services are rendered. Therefore, we ask our patients to sign a statement (included on our Assignment of Benefits form and Patient Profiles) that states that you understand that you will be financially responsible for any charges that are considered Non-Covered under your insurnace benefit plan. If you do not agree with our policy you may provide our office with written notice that you will not accept responsiblity of Non-Covered Charges. In such case, our office reserves the right to accept you as a PRIVATE PAY patient only for all future visits. As a PRIVATE PAY patient you will be seen just as any other patient without insurance and be held responsible for all charges (without benefit of insurance contract rates/discounts) additionally our office will not file insurance claims or forms on your behalf.
For Indemnity and Out-of-Network Insurance products
Many insurance companies use a fee schedule that may include providers outside of this region and may not be applicable for this geographical area. You are responsible for payment regardless of any insurance company's determination of usual and customary rates which may bear no relationship to the current standard and cost of care in this area.
In the event that your insurance coverage changes to a plan where we are not participating providers, you will be responsible for payment of all fees at the time service is rendered.
We ask that you participate in any disputes with your insurance carrier regarding your policy guidelines and insurance payments.
Our staff is trained to help you with any insurance question you may have. Remember, though, that we can only answer questions relating to how your claim was filed, and provide any additional information the carrier might need to process your claim. Coverage issues, however, can only be addressed by your employer or group plan administrator.
Although our assistance is available to you at any time, we cannot act as a mediator with the carrier or your employer.
We normally do not file claims for Out-Of-Network insurance coverage. We will provide you with a receipt that contains all of the information required for you to file your own claim.
