“What is beautiful is good, and who is good will soon be beautiful.”
-Author: Sappho
Policies and Terms
We recognize the importance of a clear and definite understanding between patient and physician regarding financial arrangements for medical care. Responding to this need and in an effort to provide consistent and high quality care for all of our patients, the following Financial Policy will be in effect for our patients:
CONSULTATION / NEW PATIENT (Insurance or Self Pay): Office visit fees range from $50 and up depending upon the complexity of each patient’s problem. Our office will file your claim to your primary and secondary insurance companies. Because we file your claims, we require complete and accurate insurance information from you before we can consider providing this service. If your insurance requires referrals to specialists, that responsibility is the patient’s. If our information is not accurate and we cannot file the claim, you will be billed for the service(s). The charges submitted to the insurance carrier will become due and payable 90 from the date of service. In the event of duplicate payment on the account by the insurance carrier and the patient, the overpayment will be refunded to the patient. Exclusions to this policy will be those patients whose primary health insurance carrier is Medicare, a Health Maintenance Organization, of Preferred Provider Organization (which pays the physician directly for services) or those patients who are being treated for an Industrial claim.
CO-PAYS/DEDUCTIBLES: You are responsible for knowing what services are covered or non-covered under your health insurance policy. All deductibles, co-payments and non-covered services are due when you see the doctor.
OUTSTANDING BALANCES/COLLECTION POLICY: If your account is more than 60 days overdue, you will be required to pay at each visit until the delinquent amount is paid in full. This is called placing the account on a “cash basis”.
MEDICARE: For those patients who are eligible for Medicare, we have joined the Federal Medicare Participating Physician Program. As a “Participating Physician”, we will accept assignments on all services covered by Medicare. This means we will accept the approved amounts as our payment in full, writing off Medicare’s non-approved portion of our charges to you. Medicare will send a check to our office for a percentage of the approved amount, minus any deductible you are responsible for. If you have supplemental insurance coverage that will cover the portion of the approved amount Medicare does not pay, please make certain we have a copy of your insurance card. Although we will accept assignment for Medicare patients, the patient will be responsible for any portion of the approved amount not covered by Medicare or a secondary insurance carrier.
WORKERS COMPENSATION: We are happy to provide treatment for work-related injuries (Workers’ Compensation). Any charges incurred for this treatment are ultimately the responsibility of the patient. With the new system Workers’ Compensation is using, it is customary to have your claim number within two weeks. We are willing to wait 30 days to allow ample time for any delays which may occur. After 30 days, if you have not supplied us with your claim number, we will be looking to you for payment. Therefore, it is in your best interest to work with your employer so that we may be supplied with the information needed to submit your claim to Workers’ Compensation for payment.
MEDICAID: We are not accepting new patients who are covered by benefits from the Ohio Department of Jobs & Family Service. We will provide treatment to our present patients who receive these benefits. Payment at the time of service is not required; however, these patients are responsible for the payment of any non-covered services they request.
LEGAL CASES: We are happy to provide treatment to patients involved in accidents, however we are not equipped to become involved in litigation. Payment is expected at the time service is rendered.
MINOR CHILDREN: The responsibility for payment of services rendered to minor children whose parents are divorced rests with the parent who seeks treatment. Any court-ordered responsibility judgment must be determined between the individuals involved, without the inclusion of our office.
It is our hope you will understand many of these credit and collection policies are required by law to assure the financial resources required to provide quality medical care to our patients and for the community.
We have been and will always be sensitive to our patient’s needs. We encourage you to contact our office if a problem regarding your account should arise.