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Summary of the Office Policies

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  • PAYMENTS DUE AT TIME OF SERVICE

    All Co-pay, Deductible, and Co-Insurance amounts are due at the time of service.

  • CANCELLATION OR APPOINTMENT CHANGES

    A $40 fee will be charged for missed appointments NOT cancelled or changed within 24 hours of appointment.

  • RETURNED CHECK FEES

    A $35.00 fee will be assessed on returned checks.

  • MINORS

    Any patient under the age of 18 must be accompanied by an adult or they will not be seen.

  • NOTICE OF PRIVACY PRACTICE

    Available upon request.

  • REFUNDS

    Refunds are mailed from our bank. Refunds are issued once claims from all dates of service are finalized.

 

Detailed Office Policy

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Arrival to the office:

New Patients

ALL new patients are expected to arrive to the office 20 minutes prior to their scheduled appointment time. As a convenience, we have provided a portal on our website to submit all information prior to your visit. We also have a printable version of the forms if you would like to bring them to your visit. If you are unable to fill out the forms prior to your visit, we ask that you arrive 30 minutes prior to your scheduled appointment time.

Late patients

If you are running late for your appointment, we ask that you contact the office to notify of us of your delay. We will determine whether or not your appointment will need to be rescheduled. If you arrive late to your scheduled appointment, we will make an effort to accommodate you, yet we reserve the right to reschedule that appointment. In certain circumstances, a missed appointment fee may apply.

Missed appointments

If you are unable to make it to your scheduled appointment, we ask that you provide 24 hours notice to either cancel or change your appointment. If you do not contact the office to cancel or change your appointment within 24 hours of your appointment, then a $40 missed appointment fee will be applied to your account.

Referrals

If your insurance requires you to have a referral, the referral must be in the office prior to the appointment or you must have the referral in your hand at the time of the visit in order to be seen. If we do not have your referral at the time of the visit, your appointment will be rescheduled. We will make every effort to remind you when a referral is required, yet keep in mind that referrals are a patient responsibility and could result in rescheduling of your appointment.

Insurance and patient responsibilities

When a healthcare provider participates with a particular insurance company, they agree to a fixed price for services rendered. This fixed-price, also known as the allowed amount, is a negotiated price between the insurance company and the provider.

In order to understand the payment process in our office, it is important to understand some of the basic terminology listed below.

What is the standard fee?

The standard fee is the amount of money that a physician charges for his or her services. The standard fee applies to services not covered by health insurance and for uninsured patients.

What is the allowed amount?

When a physician signs a contract with an insurance company, they agree to accept the amount paid by the insurance company for each service. This amount of money is known as the allowed amount. The insurance company is charged the standard fee, yet the physician is only permitted to collect the allowed amount. This money can be paid by the insurance company, the patient, or both.

What is the non-allowed amount?

The difference between the standard fee and the allowed amount is known as the non-allowed amount. The non-allowed amount, which only applies when billing an insurance company, is written off by the physician. The patient is not responsible for this money. For example, if the physician’s standard fee for an office visit is $100 and the insurance allows $60, then the non-allowed amount is $40. A payment of $60 will be made by either the insurance company, the patient, or by both the insurance company and the patient depending on the contract.

Co-payment, Co-insurance, and Deductible

Unfortunately having healthcare does not mean that all of your services will be paid by the health insurance company in full. As a patient with health insurance, you sign an agreement with the health insurance carrier that you will pay your provider out of pocket expenses. These out-of-pocket expenses are termed co-payment, co-insurance, and deductible.

What is a co-payment (co-pay)?

The co-payment represents the patient’s shared cost of the allowable amount for the service. For example, if the allowed amount for a service is $100 and the co-payment is $30, then the insurance company will pay $70 and the patient will pay the $30 co-pay.

Co-payments are typically higher for specialists as compared to primary care providers.

Co-payments are due at the time of service. Patients will not be seen without paying their co-payment.

What is co-insurance?

Co-insurance represents the percentage of payment that the patient is responsible for paying. For example, if a patient has 80% coverage for a service, they are then responsible for 20% of the allowed amount. If the allowed amount is $100, then the patient will be responsible for $20 and the insurance company will pay $80.

Co-insurance payments are due at the time of service. Patients will not be seen without paying their co-insurance.

What is a deductible?

The deductible is the amount of money that a patient must pay out of their pocket before the insurance company will make any payment for services. For example if a patient has a $1000 deductible and the insurance company allows $100 for the services rendered on that day, then the patient is responsible for $100 and $900 remains on the deductible. The insurance company will not pay any money for services applicable to the deductible until $1000 has been paid by the patient.

Deductible are due at the time of service. Patients will not be seen without paying their deductible.

Questions regarding office policy

If you have any questions regarding our office policy feel free to contact us at 410-560-2777.