We realize that our patients' time is valuable, and we make every effort to see patients at their scheduled appointment time. We ask that patients provide as much advance notice as possible when running late for an appointment or when cancelling. With this advance notice of cancellation, the time can be scheduled for another patient.
Insurance and Payment Information
We are a provider for Medicare and most major insurance plans. We encourage all patients to confirm their coverage prior to making an appointment.
If you have Medicare as your primary insurance and have a supplement insurance, please make sure Medicare is aware, as they will forward claims to your secondary insurance. It may take up to 4-6 weeks for your secondary insurance to respond with payment or denial. Should you receive a bill, verify if your secondary has paid or denied prior to submitting payment to us.
Our office will verify your benefits; however the benefits obtained are just a quoted benefit and not a guarantee of payment. Due to the variety of insurance plans, we have NO WAY of determining what your plan coverage will be or our physician’s network status with each particular plan. We ask that you confirm physician network status and if referrals or authorizations are required with your carrier. Denied or unpaid claims due to our physician’s network status, missing referrals or authorizations will become your financial responsibility. Should you have a change of address or phone number, please notify us as soon as possible.
A legal guardian must be present at every appointment in order to have services rendered.
WE DO NOT FILE SECONDARY INSURANCE CLAIMS. Should you have a secondary insurance, we can provide you with all the necessary information so that you may file your claim.
The Federal Government has informed us that we can be penalized for not collecting co-payments, deductibles and co-insurances. Therefore, all charges incurred by you or any dependents are due and payable at the time of visit unless prior arrangements have been made.
Our office will make every attempt to collect payment from your insurance company. However, any claims not paid by your insurance company within 60 days or in the event that your insurance denies a service or procedure, will become your financial responsibility. Please contact our office should you have any questions regarding balances. We will assist you to the fullest extent permitted by law.
For your convenience, our office accepts all Major credit cards, debit cards, cash, checks and Care Credit.
Please be advised that any unpaid or delinquent balances over 90 days will be sent to an outside source for collection and a 35% collection fee will be applied and will not be waived.
- Requests for medical records/x-rays require 15 days’ notice. A $25 fee will apply.
- MISSED/CANCELLED appointments without 24 hour notice will be subject to a $25 fee.
- MISSED/CANCELLED procedures without 24 hour notice will be subject to a $50 fee.
- FMLA/Disability paperwork subject to a $25 fee per occurrence.
Thank you for your cooperation.
What to Bring to Your Appointment
If you are a first-time patient, please plan on arriving early to complete a patient registration form. Please bring the following items to the appointment:
- Insurance card(s)
- Referral forms (if required)
- List of all prescription and over-the-counter medications that you are currently taking
- Any required co-payment
- Pertinent medical and surgical history information
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
|Insurance and Payment Information|
|What to Bring|