Our office does not accept checks. Forms of payment accepted are cash, Care Credit
, American Express, Discover, MasterCard or Visa debit or credit cards.
Our office does not accept or file accidental insurance. This includes but is not limited to school insurance, home owner’s insurance or private plans.
Any incident involving an automobile must be filed under the patient’s automobile insurance carrier. This includes non-collision accidents such as closing a car door on a finger or sustaining an injury while lifting a load out of a car trunk. Patients having additional personal/group insurance will be required to file the automobile insurance as their primary insurance and the personal/group as their secondary insurance. Patients that only have automobile insurance will be considered a Self Pay Patient; at this time we do not see these patients. It is illegal to bill automobile claims to a patient’s personal/group insurance until all automobile insurance benefits have been exhausted.
You agree to reimburse us the fees of any collection agency, which may be based on a percentage at a maximum of 33% of the debt, and all costs, and expenses, including reasonable attorneys’ fees, we incur in such collection efforts.
Co-payments are collected at the time of registration. Patients who are unable to pay their copayment may not be seen.
Patients with large deductibles (over $250.00) will be required to pay a deposit at check in. The remaining balance, coinsurance and or deductible and will be collected at check out based upon the insurance allowable. Patient credits will be applied to the next visit or refunded if no other appointment is necessary. Refunds are by check and will be mailed to the patient.
Forms are normally completed within 10-14 business days of receipt. The form completion prepayment is $30.00 per form, for all forms needing physician completion. The patient must sign a Consent for Release of Medical Records
before the form can be completed.
Patients requesting electronic copies of their medical records can obtain them free of charge by accessing their patient portal.
Patients requesting paper copies of their medical records must complete a signed release form. The charge is $.15 per page with a request turn around time of 10-14 business days. Records can be picked up with a photo ID; they cannot be mailed. This is to ensure patient confidentiality.
Radiology copies are provided via film or CD depending of the file type available.
Radiology films can be picked up and returned with a signed release and photo ID free of charge.
Electronic radiology copies are provided on a CD with a signed release form and photo ID at $6.50 with a request turn around time of 10-14 business days.
We are a participating provider with the Medicare Part B program; and as such we are obligated to write off the difference between what Medicare pays us for the services rendered to you ( the “allowed amount”) and our usual and customary charge. Medicare pays 80% of the “allowed amount” to us directly. The remaining 20% co-pay and your annual deductible of $166 are the patient’s responsibility by federal law. We do not manually file claims to your Medicare supplement. If Medicare transmits your supplemental information for payment to your insurance company, we will allow 30 days for payment. After 30 days, if payment has not been received by our office, payment of the 20% co-pay to our office and collection from your supplemental insurer will be your responsibility.
A $200.00 new patient / $100 established patient no show fee may be applied to the patient’s account when the patient has not given adequate notice (more than 24 hours) of an office appointment cancellation. Two no show appointments will result in termination of care. If a patient who has not established with the practice misses their first appointment on two separate occasions, they will not be scheduled for any further appointment.
Promissory notes are only a courtesy for patients usually seen through the emergency room when Dr. Patterson is the covering physician. Patients are required to set up payment arrangements at the time of check in for their first office visit. Patients should be prepared to make a payment on their first visit. Any patient not in compliance with the terms of their promissory note will be sent to an outside collection agency.
Patients will be refunded any overpayment once all claims on the account have been processed and the patient has been discharged from care. The refund may be refunded back to the credit card of the original payment at the patient’s request. For all other forms of payment, a refund check will be issued by the accounts payable department in a timely manner. Please note all checks are mailed certified return receipt which requires a signature upon USPS delivery.[/tab]
Our office does not bill commercial secondary insurance. It is responsibility of the patient to remit payment based upon their primary insurance benefits.
All patients without insurance will be required to pay a deposit at check in ($500.00 for non-fracture care and $750.00 for patients with a fracture). Any remaining balance for the visit will be collected at check out. Self pay patients paying their bill in entirety at check out are entitled to a 33.3% discount. This discount does not apply to patients with insurance. Refunds will be paid as per our refund policy (See above).
Patients, who cancel their surgery with less than 24 hours notice, will be charged a $200.00 fee for the late cancellation.
Patients are required to pay their portion of the surgical fee two (2) business days prior to the surgery. Patients unable to pay may be required to have their surgery rescheduled.
Any international patients who have Canadian health care insurance or traveler’s insurance, automatically become Self Pay patients. The patient will be responsible for charges at the time of service. It is the patient’s responsibility to file their claim with the insurance company. Our office would be happy to assist you with this.
If a patient is injured on the job it must be reported to the employer unless they are worker’s compensation exempt. The initial appointment is to be handled through the worker’s compensation adjustor. If the employer is worker’s compensation exempt, you must provide a copy of the state exemption. Any non-participating worker’s compensation carrier will be required to sign our worker’s compensation agreement before making any appointments for the patient. The adjustor will be required to provide any non-English speaking patient with a translator.