Insurance/Patient Financial Responsibility
Please Review This Notice Carefully.
In addition to traditional Medicare, the insurance plans with whom we participate are too numerous to list here. As your insurance coverage is a contract between you and your insurance carrier, if you have questions regarding your coverage, it is best that you contact your carrier directly.
When an appointment is made, we will collect your insurance information from you. Your benefits will be verified prior to your appointment. We will collect any co-pay, co-insurance, and/or deductible based on the summary of benefits obtained from your insurance carrier when you check in for your appointment and prior to any procedure performed. Outstanding balances due will also be collected at check-in.
If your insurance plan requires one, it is your responsibility as a patient to provide us with a current authorization/referral. Please contact your primary care physician in advance to allow sufficient time for us to receive the authorization. If no authorization is received prior to the time of your appointment, your appointment will be rescheduled for a later date.
Please be sure to bring your insurance card(s), a picture ID, a list of your medication (both over-the-counter and prescription), and your pharmacy phone number to our office on the day of your appointment.
As a courtesy to our patients, we will file claims with your primary and if you have one, with your secondary insurance carrier. Regardless of the insurance company’s response, it is the responsibility of the patient to make payment in full for services received. If at any time your insurance company fails to render payment, it then becomes your responsibility to submit payment.
Unless prior arrangements have been made, self-pay/cash patients are required to pay for their office visits and/or procedures at the time they occur.
We acknowledge that financial problems may arise affecting timely payment on your account balance. We encourage you to contact us promptly for management of your account.