Thank you for choosing us as your healthcare provider. We are committed to providing you with the best possible medical care. You clear understanding of our practice’s financial policy is important to our professional relationship. We are sure you understand that payment for this healthcare is your responsibility. Please read this carefully and if you have any questions, please do not hesitate to ask any member of our staff. Please have the following available at Patient Check-In:
Current Photo I.D. or Driver’s License
Health Insurance card
Current Personal Contact Information (address, name, insurance information).
Payment of any Outstanding Balance
Payment for Today’s Visit
Payments: Payment is expected at the time of your visit. For your convenience, we accept cash, personal check, or Visa, MasterCard and Discover. If you do not have your co-payment your appointment may be rescheduled. If it is necessary that you be seen, a co-pay service charge will be added to your account. Insurance: We are participating providers with several insurance plans. We will file all of these insurance claims. A list of these insurance plans is available upon request. Please remember that insurance is a contract between the patient and the insurance company and ultimately the patient is responsible for payment in full. If your insurance company does not pay the practice within a reasonable period of time, you will be billed. If we later receive payment for your insurer, we will refund any overpayment to you.
If our doctors are not listed in your plan’s network, you may be responsible for partial or full payment. If you are insured by a plan with which we have no prior arrangement, we will prepare and send the claim in for you on an unassigned basis. This means the insurer may send the payment directly to you and therefore, our charges for you are due at the time of service. Due to the many different insurance products out there, our staff cannot guarantee your eligibility and coverage. Be sure to check with you insurer’s member benefits department about services and physicians before your appointment. Many web sites have erroneous information and are not a guarantee of coverage. You are responsible for obtaining a properly dated referral if required by your insurer and responsible for payment if your claim rejects for the lack of one.
Not all insurance plans cover all services. In the event your insurance plan determines a service to be non-covered, out-of-network or not medically necessary, you will be responsible for the complete charge. Payment is due upon receipt of a statement from our office. All procedures billed in this office are considered covered unless limited by your specific insurance policy. No Health Insurance Patients: Patients who do not have individual or group health insurance, payment is expected for all services at the time of your visit. At this time, no discounts are available to patients with or without health insurance. Returned Check Fees: A $30.00 service fee will be charged for any checks returned for insufficient funds, plus any bank fees incurred. Cancellations or Missed Appointments: If you do not cancel your appointment at least 24 hours prior to your appointment or if you are a no-show, we will assess you a $25.00 missed appointment fee. Delinquent Accounts: Patients with a delinquent balance are required to make payment in full for future services.
A delinquent account is defined as patient balance that is 90 days or greater. If such payment is not made, services may be refused. Payment Plan: Please let us know if you are having difficulty paying your account balance. We may be able to set up a payment plan on your financial hardship. Please call our Billing Office at 561-746-1354 for approval. Responsibility for Payment: I understand that I, personally, am financially responsible to Andrea’s Medical Office, P.A, for charges not covered by the assignment of insurance benefits. Release of Information: I hereby authorize the and direct Andrea’s Medical Office, P.A., to release to insurance carriers, governmental agencies, or others that are financially liable for such professional and medical care, all information needed to substantiate claim and payment.
Thank you for understanding our financial policy. Please sign below. I have read and understand this office financial policy and agree to comply and accept responsibility for any payment that becomes due as outlined above.
Developing and implementing this financial policy is critical for my office’s financial success. It will help patient’s understand their obligations, avoid any misunderstandings and provide payment options. Also, it will reduce the amount of unclaimed revenue, maintain a good relationship with the patients and encourage their loyalty. It will allow us the ability to continue to provide quality health care to patients.
A successful medical office does not just revolve around a strong financial policy. It also depends on how it is presented by the office staff. It is important that the office staff provide customers service by being warm, empathetic, and knowledgeable. My staff will be kept up-to-date on policies and procedures, processing of billing, contacting insurance companies for needed information, working with medical coding or billing staff and closing out any residual billing or account issues. Also, training sessions will be provided to staff members for tasks for which they are accountable for. Making sure we do our due diligence to keep patient demographics accurate, medical coding is done correctly while being in compliance with state and federal laws will ensure patient confidence and prevent insurance overpayment etc.
I am confident that this financial policy and knowledgeable staff will allow the practice to operate in an effective, efficient, profitable, and professional manner. Also, it will help achieve my practices objectives, provide high-quality service and flexibility to our patients.
References
Valerius, J., Bayes, N., Newby, C., & Blochowiak, J. (2014).
Medical insurance: An integrated claims process approach (6th ed.).
Boston, MA: McGraw-Hill. Cascardo, Debra, MA,M.P.A., C.F.P. (2012).
You must have financial office policies in place to maximize your profits: Part I. The Journal of Medical Practice Management : MPM, 28(1), 9-80. Retrieved from http://search.proquest.com/docview/1242495553?accountid=458 Mikalac, C. M. (2007).
Financial policies, money transference, and nonpayment. Psychiatric Times, 24(8), 52. Retrieved from http://search.proquest.com/docview/204566314?accountid=458 Alliance Medical Group Financial Policy. (2014).
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