Financial Policy
We hope that you will recognize that our financial policy is a necessary part of assuring the resources required to maintain this health care service for our patients and for the community. Charges for medical services are due and payable at the time services are rendered. Charges for medical care provided by this medical practice are billed through our office and should not be confused with charges for medical care provided by the hospital. We accept Visa, MasterCard, as well as personal checks, money orders, and cash. We bill your insurance company for your health care costs. It is extremely important that we obtain complete information about your primary and supplemental insurance companies, including phone numbers, addresses, and subscriber's date of birth. We will also use this information to help you with your insurance company's preauthorization process. Preauthorization and occasionally second surgical opinions are requirements by most insurance companies. We insist that when a surgery or procedure (MRI scans, CT scans, outpatient surgery) is scheduled, that you contact your insurance company immediately to determine what, if any, preauthorization requirements the insurance company deems necessary before the surgery or procedure. We will not continue with surgery plans if the insurance company denies benefits. You will need to initiate the communication between you and the insurance company. We cannot stress enough how important it is for you to be aware of your insurance company's requirements on hospitalization and surgery. Your insurance company may deny payment or drastically reduce payment for services provided to you if their requirements are not met. If you have health insurance, it should be understood that this is an agreement between you and your insurance company. Your doctor's bill, on the other hand, is an agreement between you and your doctor. You are responsible for the payment of your doctor's bill regardless of the status of your insurance claim. If unusual circumstances make it impossible for you to meet our credit terms, we invite you to call or personally discuss the matter with our business department. This will avoid misunderstandings and enable you to maintain your account in good standing. Except when hardship or previous credit arrangements warrant otherwise, accounts 90 days past due are referred to a collection agency. Your account with us is then considered terminated. Contracted Insurance: We contract through Brown and Toland Medical Group and many PPOs. Please ask our receptionist if your insurance company is in this contracted category. If you are enrolled with one of these companies, you will pay only the co-pay and deductible fees that are predetermined by your insurance group or employer. You will be asked to pay any co-pays, deductibles and co-insurance at the time of service. Some services may be deemed non-covered or medically unnecessary by your insurance company. If so, you are directly responsible for the charges incurred. Any balance remaining after the insurance payment is made is due to our office within 30 days. Non-contracted Insurance: Patients who have policies with non-contracted insurance companies will be responsible for payment of all office visits at the time of service. Medicare: We accept assignment from Medicare, so all payment from Medicare is made directly to the doctor. We bill Medicare and your supplemental insurance directly. We are required by Federal Law to collect the amount Medicare approves not just the 80% they pay. This means that the patient pays 20% of the approved charge either out of pocket or through their supplemental insurance. If you do not have a supplemental insurance, is due to our office within 30 days. We do not accept assignment from Medi-Cal. If you have Medi-Cal as a primary insurance, you are responsible for all charges and payment is due at time services are rendered. If Medi-Cal is your supplemental insurance you are responsible for any coinsurance remaining after payment from your primary insurance. We will work with patients in any way we can to ensure that their medical care is the finest available and the care does not become a financial burden.