We will bill your insurance company as a courtesy. Your insurance policy
is a contract between you and your insurance company. It is your responsibility
to know your benefits and how they will apply to your treatment by the
doctor. We are not a party to that contract. If your insurance company
has not paid your account in full within 60 days, the balance will be
transferred to you and/or the guarantor listed on the Patient Information
form. If unable to make payment in full, contact the billing department
immediately to make payment arrangements. If the account is referred for
collections, you will be responsible for the balance of your account plus
a collection agency charge of 25% of the balance and reasonable attorney’s
fees. If your account becomes delinquent or is referred for collections,
your provider and/or any collection agent of your provider has authorization
to obtain your credit report to assist them in the collection of your bill.
HMO Plans (with which we are contracted): All co-pays must be satisfied at every visit. There can be no exceptions
due to contractual and uniform compliance issues with your insurance company.
You are responsible for obtaining prior approval with your Medical Group
or PCP prior to treatment.
PPO Plans (with which we are contracted): We have agreed to take a discount from your insurance company. Your co-insurance
is your responsibility and is due at time of treatment. In the event your
insurance coverage changes to a plan where we are not a participating
provider you will be responsible for any out-of-network deductible or
Medicare: We accept assignment with Medicare. Medicare pays 80% of their allowed
amount after satisfaction of the yearly deductible. You are responsible
for 20% of Medicare’s allowed amount. We will bill your secondary
insurance as a courtesy.
Usual and Customary Rates
Our practice is committed to providing the best treatment for our patients
and we charge what is usual and customary for our area. You are responsible
for payment regardless of any insurance company’s arbitrary determination
of usual and customary rates.
Self Pay Patients
All services must be paid in full at time of treatment.
A $25.00 fee will be charged for any returned checks. We will be unable
to accept your check for any services thereafter.
Thank you for understanding our Financial Policy. Please let us know if
you have questions or concerns. You can reach the Business Office Manager
or Chief Operations Officer at (949) 722-7038.