Thank you for choosing us for your medical care. The following is a statement of our
Financial Policy which we ask you to read and sign prior to any treatment.
All patients must complete our General Information form and Medical History form
before seeing the doctor. If belong to an insurance or managed care plan, please let us
know beforehand.
We accept cash. We do not accept checks or credit card at this time.
If you belong to HMO or PPO that requires co-payment, you will be asked to pay
this prior to seeing the doctor.
REGARDING MEDICAL INSURANCE…
Your health insurance policy is a contract between you and your insurance
company. Any disputes regarding medical coverage should be addressed directly to
them.
If you belong to an HMO, PPO, or any other managed care plan in which we
participate, we will automatically file your insurance claim for you. You are
responsible for obtaining any required authorization, pre certifications,
and/or referrals prior to your visit.
If a treatment or procedure is performed here and is deemed not payable by
your insurance company (e.g. annual physicals, preventive immunization,
etc), you will be held responsible for payment in full.
If you are a Medicare beneficiary, we will file your claim directly with
Medicare for you. If you have secondary insurance, we will bill them for the
balance portion Medicare does not pay. However, you remain responsible
for the annual deductible as well as any remaining co-payments. If you have
a third party insurance, you will be responsible for filing your own claims
with them.