| Patient Payment Policy |
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Please review the following policy for an understanding of what is expected in your situation. If You Have Commercial InsuranceAlso known as indemnity, "regular" insurance, or "80%/20% coverage." Patients are Responsible for:Payment of all office visits, x-rays, injections, and other charges at the time of office visit. Staff Will:Call your insurance company ahead of time to determine deductibles and coinsurance (as time allows). File an insurance claim as a courtesy to you. If You Have HMO & PPO plans with which we have a contractPatients are Responsible for:If the services you receive are covered by the plan: All applicable copays are expected at the time of the office visit. Staff Will:Call your insurance company ahead of time to determine copays, deductibles, and non-covered services. If You Have HMO with which we are not contractedPatients are Responsible for:Payment in full for office visits, x-rays, injections, and other charges at the time of office visit. Staff Will:Staff will collect $200 before the first visit and the balance will be collected on check out. If You Have PPO with which we are not contractedPatients are Responsible for:Payment of the patient responsibility - deductible, copay, non-covered services - at the time of the visit. Staff Will:Call your insurance company ahead of time to determine out of network benefits, copays, deductibles, and non-covered services. File an insurance claim on your behalf. If You Have MedicarePatients are Responsible for:If you have Medicare as primary, and also have secondary insurance or Medigap: No payment is necessary at the time of the visit. (COG is not a participating provider with any Medicare HMO's.) Staff Will:File the claim on your behalf, as well as any claims to a secondary insurance. If You Have Workers CompensationPatients are Responsible for:If we have verified the claim with your carrier and/or employer, no payment will be requested at the time of the visit. If we are not able to verify your claim, payment in full is expected at the time of your visit. Staff Will:Call your carrier/employer ahead of time to verify the accident date, claim number, primary care physician, employer information, and referral process. Staff will collect $200 before the first visit and the balance will be collected on check out. If You Have Workers Compensation (Out of State)Patients are Responsible for:Payment in full is expected at the time of the visit (Self-Pay). Staff Will:Staff will collect $200 before the first visit and the balance will be collected on check out. If You Have No InsurancePatients are Responsible for:Payment in full at the time of the visit. Staff Will:Staff will collect $200 before the visit and the balance will be collected on check out.
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