Hanover Orthopaedic Associates, Inc. is dedicated to providing our patients with the best possible care and services while keeping the costs to you from increasing at an unreasonable rate. We ask your help by understanding and cooperating with our financial policy.
INSURANCES:
We participate with several insurance companies. Please check with the Billing Dept. to see if we participate with your plan.
If we DO participate with your insurance company, all services performed by us 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.
CO-PAYS
The patient is required to present an insurance card at each visit. All copayments and past due patient balances are due and payable at the time of service. If copayments are not paid, the patient’s appointment may be rescheduled by the practice and the payment must be paid before the next scheduled visit.
REFERRALS:
If your insurance has designated a primary care physician (PCP), you are required to have prior authorization from your PCP prior to your visit. You may use the office telephone to obtain the authorization. If this authorization is not provided on the day of service, you will be asked to either reschedule your appointment or pay for your visit at time of service. We are notifying you of this policy in writing regardless of our agreement with your insurance company.
If we DO NOT participate with your insurance company, this means that we will bill your insurance company as a courtesy to the patient; however, in most cases since we do not participate with your insurance, you will receive the check and must mail the payment to us directly. We do not accept payment from them as payment in full for the services performed. All insurance carriers have a schedule of fees from which they will pay; however, the doctor’s fees may be more than what the insurance company shows on their schedule. Therefore, any balance not covered by the insurance company becomes the responsibility of the patient. Payment for office visits IS due at the time of service.
It is important for your to understand that your health insurance coverage is an agreement between YOU and YOUR INSURANCE COMPANY and your doctor’s bill for the services provided to you is an agreement between you and your doctor.
PAYMENT FOR SERVICES PERFORMED:
Our office accepts VISA, MasterCard, Discover and Bank Cards for your convenience, as well as cash or a check. All payments are expected at the time of service and any outstanding balances are due within 30 days, unless prior arrangements have been made with the Billing Department. Past due balances may be assessed at 1.5 percent per month finance charge after 60 days. All balances that reach 90 days past due will be sent to a collection agency. Should your account be sent to a collection agency, you will be financially responsible for all collection fees and legal fees that our office incurs through the process utilized to collect the outstanding delinquent balance.
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.
We must emphasize that as physicians, our relationship is with you, NOT your insurance company. While the filing of insurance claims is a courtesy that we extend to our patients, all charges are strictly your responsibility from the dates services are rendered. Therefore, it is often necessary for you to inquire and explore your benefits with your insurance carrier. We realize that temporary financial problems may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account.
Our fees are generally considered to fall within the acceptable range of other orthopaedic practices in our area. This applies only to companies that pay a percentage (such as 50% or 80%) of “U.C.R.” which is defined as usual, customary, and reasonable by most companies. This statement does not apply to companies who reimburse based on arbitrary “schedule” of fees, which bears no relationship to the current standard and cost of care in this area. Not all services are a covered benefit in all contracts. Some insurance companies arbitrarily select certain services they will not cover.
We are committed to providing you with the best care possible. If you have medical insurance, we are pleased to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance, and your understanding of our payment policy.
Returned checks and balances older than 30 days may be subject to additional collection fees and interest charges of 1.5% per month. Charges may also be made for broken appointments and appointments cancelled without 24 hours advance notice.
PATIENT REFUNDS:
The following criteria MUST be met prior to issuing a refund: The patient has not been seen in the office for 90 days, there is no outstanding insurance claim on the patient’s account; and there are no outstanding patient balances on the account.
We will gladly discuss your proposed treatment and answer any questions relating to your insurance. It is your responsibility to provide us with this important information as well as your signature on the Consent and Authorization Form.
WORKERS’ COMPENSATION CASES AND LIABILITY CASES:
We will send appropriate claim forms for services rendered on your behalf. If a claim is denied we will expect payment from the patient within 30 days of receipt of our bill. If the patient has other insurance options, Hanover Orthopaedic Associates, Inc. will cooperate whenever possible in assisting in his/her efforts to be reimbursed from the source,
In order for Hanover Orthopaedic Associates, Inc. to provide the quality of care it offers, you must be willing to do your share in helping us to help you receive insurance benefits for which you are fully entitled.