We have tried to answer many of the questions we receive in regards to paying for services and how to better work with insurance carriers. Your questions are as important as our answers – this page will continue to be developed as we hear from our patients and future customers.
What method of payment do you accept?
We accept cash, debit cards or credit cards. The cards we accept are: Visa, MasterCard, American Express and Discover. We understand payments submitted by mail may need to come in the form of a check so we do make an exception to our policy not to accept checks in that case, however please be aware there is a $25 NSF or Returned Check Fee. These fees and any other balances related to the returned payment must be paid in full prior to being seen for any future appointments.
Do you offer self pay discounts?
We make a 25% adjustment to all billable charges for patients without insurance.
How much time prior to the birth do I need to have my bill paid?
Our billing office will review your insurance plan as well as some parts of your medical history relating to your pregnancy, an OBPRE payment arrangement will then be drafted with your expected out of pocket in total as well as the monthly payment that is expected. We will typically start these payments at or around your 12th week of pregnancy and expect the balance to be paid by your 32nd week. These expenses are estimated to the best of our ability according to the benefit information available. If your care changes during the pregnancy or delivery the charges will change accordingly. We will make those adjustments during your final billing process and you may or may not have either a balance or credit. Once all your claims are processed and completed you will receive a statement or a refund will be processed. The charges in your OBPRE are for your global charge of prenatal, delivery and postpartum care. Any Sonograms, Labs, Injections, Diagnostic Testing or increased number of visits will be billed individually and paid as such. Once the claim is processed and paid by your insurance we will send you a statement for any remaining balance.
How do I get a refund if I paid for one service and another type of service was provided?
Once we have received your insurance reimbursement a check will be issued to you for any overpayment. Once a credit is identified our billing staff will review your account for accuracy of the credit and any pending claims. If it is found the credit is correct and there no open claims we will submit your refund request to the practice administrator for payment. The entire process can take up to 6 weeks.
Do you accept most insurance?
We accept most insurance, including some Medicaid. Although our physicians may be in network or participating with an insurance company there are times when they may not be accepting new patients with that insurance. If you are established with our practice and change to an insurance your physician isn’t accepting new patients with you would still continue your care without any problems. Because there are many facets of an insurance plan we require patients to be familiar with your plan and the requirements of your insurance company and the services that are covered and not covered. We do our best to assist you and obtain some information however your coverage is a contract between you and your insurance company. Ultimately, they make final determination on payments or denials.
Do you submit insurance claims? Will you help my claim get paid?
Yes, as a courtesy to our families, we will submit insurance claims and will work with you and the insurance company to get your claim paid. However, submitting a claim does not guarantee the insurance company will pay for the service that was rendered.
What can I do to help get my insurance claim paid?
- Understand your benefits by:
- Reviewing your plan
- Reviewing your plan’s website
- Speaking with customer service when you have questions
- Asking your Human Resource questions
- Bring your insurance card with you at each visit.
- Bring in both cards if you have two policies.
- Provide us with a copy of the front and back of the card.
- Notify us as soon as possible a carrier change.
- Respond ASAP to a carrier when information is needed.
- Remember carriers WILL NOT pay until information is received – information MUST be received within THEIR time frames.
- Notify the carrier ASAP when adding a newborn, child or an event change.
- Provide us with your up-to-date contact information.
- Consider our Billing Department as part of YOUR team.
What happens when I am having trouble getting the insurance to pay?
When an insurance company refuses to pay, the outstanding amount becomes your responsibility. We will work with you as part of your team in every way to help you get your claim paid.
What will I be required to pay for the visit and service?
Most all insurance carriers, in their contract with us, require we collect a patient’s out of pocket responsibility at the time of service. This would include Co Pay, Deductible and or Co Insurance as it applies to the service you are having. We review your appointment and your benefits and estimate the amount expected to be due by you once your insurance pays and we adjust our contractual charge amount. Please also keep in mind the physician, at the time of your visit, may order additional tests or procedures. The costs for these additional services may or may not be covered by your insurance. Proactively knowing your benefits before coming to the office visit is helpful.
Self Pay patients are, in the same way, required to pay for all services rendered at the time of their visit.
When will I receive notice of what amount is still due?
Each month you should receive a bill which will state the amount that is due. Payment is due upon receipt of the statement.
What do I do when I have another child to add to my insurance policy?
When there is a dependent status event change in your family such as a birth, adoption or an extension to your family, although this time is hectic, please call your insurance carrier or your employer and report the change.
How long do I have to report a change to my insurance carrier?
A change, generally, should be reported within thirty days. We strongly recommend reporting the change as soon as possible. Failure to report a change timely may result in the carrier not honoring benefits. If benefits are not honored, the full responsibility of payment for bills accrued during this time will be passed on to the patient or their responsible party.
Fees for Forms or Other Paperwork
At times you may require physician statements, FMLA, Short Term Disability or other forms to be completed by your physician for your employer, insurance company, etc. These can sometimes be as simple as a one page form needing basic information to several pages that are more complex. All forms turned into the office will be billed a flat fee of $25. This is payable prior to picking up or receiving them from our office. Typically this is when they are dropped off.
We ask you allow at least 5 business days for us to process. Keep in mind it may not take as long, or in some cases it may take longer. Either way, we will contact you upon completion to coordinate either pick up by you or us faxing to the recipient you authorize.