We participate with several insurance companies. If you have questions regarding your particular insurance plan, please call Patient Accounts at 610-692-3434, ext 707.
If we DO participate with your insurance company, all services performed in our office and at the hospital will be submitted to them, unless we have received prior notification of non-covered services. All co-pays and deductibles are the patient’s responsibility. A prepayment plan will be set up regarding obstetrical care and surgery.
It is important for you to understand that your health insurance coverage is an agreement between you and your insurance company. It is also important for you to know all of the specific requirements of your insurance, especially co-pays and which labs we are authorized to use. Your physician’s bill for the services provided to you is an agreement between you and your provider. If you receive a statement from our office and disagree how your insurance carrier processed the claim, please call your insurance carrier directly.
Coordination of Benefits:
Most insurance carriers send letters to subscribers the first of the year requesting information in regard to whether the subscribers, or dependents, have any other insurance coverage. This information must be completed. For children covered under both parents' policy, the Birthday Rule applies. In this case, the primary insurance would be the parent whose birthday falls first in the calendar year (not who is older). For this reason, we need to have birthdates on file in our office. This issue occurs frequently with college students. Your insurance will not pay on claims until they receive this information. If you have questions, please call our Patient Accounts division.
Cancellation: (office visits, procedures and surgery)
We expect you to notify the office within 24 hours if you are unable to keep an appointment. Our telephone system is able to take messages 24 hours a day to accommodate notification for scheduling changes.
Payment for services performed:
Our office accepts Visa, MasterCard, Discovery and debit cards for your convenience, as well as cash or check. All payments are expected at the time of service delivery and any outstanding balances are due within 30 days, unless prior arrangements have been made with Patient Accounts. All balances that reach 60 days past due with no activity will be sent to a collection agency. Should your account be sent to a collection agency, you will incur an additional $25 service charge.
Payment in full of any past due balance is expected prior to being seen in our office in the future. In addition, payment in full will be expected at the time of service for any future services.
Refunds will be sent within thirty days of payment. If you have not received an anticipated refund, please call Patient Accounts at the above number to make an inquiry.
As a Medicare participant it is required that you sign an Advance Beneficiary Notice(ABN) upon check in for your office visit. An Advance Beneficiary Notice is a written notice from Medicare given to you before receiving certain items or services, notifying you:
- Medicare may not cover a specific procedure or treatment
- ”Non-covered” services by Medicare are usually not covered by supplemental insurance and are billable to the patient.
Medicare requires our office to have you sign this form prior to services being rendered. An ABN gives you the opportunity to accept or refuse the items or services and protects you from unexpected financial liability in cases where Medicare deems non-covered. It also offers you the right to appeal Medicare’s decision.