Insurance
If you have insurance coverage, we will prepare and submit a standardized insurance claim form to your insurance company for services rendered during a hospitalization or emergency room treatment.
However, RESPONSIBILITY FOR PAYMENT IS YOUR OBLIGATION REGARDLESS OF INSURANCE OR ANY OTHER CIRCUMSTANCES (SUCH AS LITIGATION).
You will be asked to sign "benefits assignment portion" of the insurance claim form before the form is submitted. This authorization for the payment to be made directly to us must be signed or the bill paid in full prior to completion of the form. If overpayment occurs a refund will be made to you.
Many insurance companies, including Medicare, have deductibles and percentage allowances, therefore, they do not cover the entire bill. An experienced financial counselor is available to help answer your questions.
Insurance Information
Managed Care
Most of our patients are covered under a Preferred Provider Organization (PPO) plan. First, be certain the doctor you are seeing is on your "plan". Do not rely on the booklet you received from the company to be accurate. Doctors are being added and deleted almost daily. Check with our receptionist- she should be able to tell you if our doctors are or are not on your plan. If you are changing to a different PPO it is best to check with all your current doctors, to be certain they are on the plan, before enrolling.
Some of our patients are covered under a Health Maintenance Organization (HMO). HMO's require patients to have a referral from their primary care physician prior to seeing a specialist. There is a good reason for this- it prevents patients from seeing specialists for minor problems that can very adequately be handled by the primary physician. This helps keep the overall expense of health care down, and is a policy we support in most cases. The problem with this is that we are not allowed to see a patient without the referral. If you come to the office without a referral you cannot be seen. Please realize that this is a "rule" we were given when we signed up to be on the insurance plan, and is not something that anyone in our offices can do anything about. Therefore, please be certain you have a referral with you before you come to the office. If there is going to be a delay in obtaining one, we would rather reschedule your appointment than inconvenience you by having you come in only to be informed that you cannot be seen because the referral has not been obtained. If there is any part of this you do not understand, please talk to one of our office managers. They will be glad to assist you.
Workmen's Compensation
In all workmen's compensation cases, the patient must be "verified" with the insurance carrier prior to treatment being rendered. If you are seeking a "second opinion" with one of our doctors, or are switching from another doctor to one of the doctors in our group, you need to make this very clear in that workmen's compensation requires special forms to be filled out under these circumstances. Workers compensation patients will not be allowed to have more than two rescheduled or canceled appointments, without jeopardizing their off-work status.