Insurance We participate in most insurance plans. You will find a complete list of insurance plans under Patient Information. If you do not find your insurance carrier listed, please call your insurance carrier. If you are insured by a plan in which we do not participate, payment in full is expected at each visit. Because there are so many different insurance plans it is not possible for us to know the specific details of every plan. Your insurance policy is an agreement between you and the insurance company. Take the time to read your policy. It is best to know what your insurance company will cover before services are received. If you still have questions about your coverage, call your insurance company.
Co-payments All copayments must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments from patients can be considered fraud. We must ask for your cooperation in this matter.
Deductibles Many insurance plans require you to pay a deductible before they will begin to pay. If you are covered by such a plan, you may be required to prepay your deductible.
Proof of Insurance All patients must supply us with an up-to-date insurance card. If you fail to provide us with your current insurance card, payment in full for all services is required until you supply the current insurance card.
Claims Submission We will bill your insurance carrier and assist you in any way we reasonably can to help get your claims paid. If your insurance does not pay your claim within 90 days, you will be billed for the service. Your insurance company may ask you to supply certain information in order to process your claim. It is your responsibility to promptly comply with their request. If the insurance company cannot complete processing of your claim because you have not responded to their request for information, you will be billed for the services.
Workers’ Compensation Authorization. You must have authorization from your Workers’ Compensation carrier in order to be seen by our physicians. This authorization must be in our office prior to your initial visit. If we do not have the required authorization, your visit must be rescheduled until it is obtained or you can be seen on a self-pay basis and pay for your services rendered that day.
Payment We can bill Workers’ Compensation only if your claim is active and the condition our physician is treating you for is allowed on your claim. If your claim or condition has not been allowed within 90 days, we will look to you for payment of your services. You will be reimbursed if/when Workers’ Compensation pays for your services. We suggest that you work closely with your employer and Workers’ Comp case manager to assure that your claim is allowed within the 90 day time frame. Any services not covered by Workers’ Compensation are the responsibility of the patient.
Self Pay Payment Policy If you are not covered by any type of insurance coverage, our office can offer you a self-pay discount. In order to qualify for the discount you must pay for all services at the time of your visit.
Patient Payment Policy Upon receipt of payment from your insurance, any services, or portion of services, not covered by your insurance plan will be billed to you. We understand that there may be situations that prevent you from paying your full balance. Please call our office at 937-298-9381 and speak with our accounts manager to set up payment arrangements on your balance due. If your account is over 90 days past due and you do not have a payment arrangement, or have not honored your payment arrangement, your account may be turned over to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by certified mail that you have 14 days to find another physician. During that 14 day period you will be seen only on an emergency basis.